Provider Demographics
NPI:1952537409
Name:TATO HEALTHCARE AGENCY, INC.
Entity Type:Organization
Organization Name:TATO HEALTHCARE AGENCY, INC.
Other - Org Name:TATO HEALTHCARE AGENCY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:K
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-298-1111
Mailing Address - Street 1:325 CEDAR ST
Mailing Address - Street 2:DEGREE OF HONOR BLDG., SUITE # 305
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1015
Mailing Address - Country:US
Mailing Address - Phone:651-298-1111
Mailing Address - Fax:
Practice Address - Street 1:325 CEDAR ST
Practice Address - Street 2:DEGREE OF HONOR BLDG., SUITE # 305
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1015
Practice Address - Country:US
Practice Address - Phone:651-298-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN163W00000X, 163WC1600X, 163WH0200X, 163WR0400X, 164W00000X, 251E00000X, 251F00000X, 251J00000X, 253J00000X, 253Z00000X, 3747A0650X, 3747P1801X, 374U00000X, 376J00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff DevelopmentGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitationGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No253J00000XAgenciesFoster Care AgencyGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN9963472OtherUCARE
MN9963472OtherBLUS PLUS
MN9963472Medicaid
MN9963472Medicaid