Provider Demographics
NPI:1952995987
Name:TACHA FAMILY HOME HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:TACHA FAMILY HOME HEALTH CARE AGENCY
Other - Org Name:TACHA FAMILY HOME CARE LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN BAPTISTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-281-0295
Mailing Address - Street 1:2416 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6607
Mailing Address - Country:US
Mailing Address - Phone:954-589-5565
Mailing Address - Fax:954-589-5568
Practice Address - Street 1:2416 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6607
Practice Address - Country:US
Practice Address - Phone:954-589-5565
Practice Address - Fax:954-589-5568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-20
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000000OtherPRIVATE INSURANCE