Provider Demographics
NPI:1811151301
Name:TNB ENTERPRISES LLC
Entity type:Organization
Organization Name:TNB ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNERS
Authorized Official - Prefix:MS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BERARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-786-1000
Mailing Address - Street 1:9298 CENTRAL AVE NE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55434-3425
Mailing Address - Country:US
Mailing Address - Phone:763-786-1000
Mailing Address - Fax:763-786-9440
Practice Address - Street 1:9298 CENTRAL AVE NE
Practice Address - Street 2:SUITE 404
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55434-3425
Practice Address - Country:US
Practice Address - Phone:763-786-1000
Practice Address - Fax:763-786-9440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN340254251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health