Provider Demographics
NPI:1932451630
Name:T&N RELIABLE NURSING CARE, LLC MA
Entity Type:Organization
Organization Name:T&N RELIABLE NURSING CARE, LLC MA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KOMLAGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EDJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-533-8111
Mailing Address - Street 1:31 AUBURN ST STE L
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-2417
Mailing Address - Country:US
Mailing Address - Phone:774-823-3523
Mailing Address - Fax:774-823-3525
Practice Address - Street 1:31 AUBURN ST STE 300
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2417
Practice Address - Country:US
Practice Address - Phone:774-823-3523
Practice Address - Fax:774-823-3525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA227571Medicaid