Provider Demographics
NPI:1982061065
Name:TATLONGHARI ENTERPRISES INC.
Entity Type:Organization
Organization Name:TATLONGHARI ENTERPRISES INC.
Other - Org Name:MOTHER'S BEST CARE FOR ELDERLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORP. SEC. / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TATLONGHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-382-1034
Mailing Address - Street 1:1225 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-1546
Mailing Address - Country:US
Mailing Address - Phone:702-382-1034
Mailing Address - Fax:702-382-1034
Practice Address - Street 1:1225 S 8TH ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-1546
Practice Address - Country:US
Practice Address - Phone:702-382-1034
Practice Address - Fax:702-382-1034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV305AGC-21320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005034689Medicaid