MEDICARE: TCHIENZONNIE HOME SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1760313357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TCHIENZONNIE HOME SERVICES LLC

Provider Business Mailing Address
First Line	:	512 45TH ST S APT 102
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58103-1030
Country	:	US
Telephone Number	:	267-665-8611
Fax Number	:

Provider Business Practice Location Address
First Line	:	512 45TH ST S APT 102
Second Line	:
City	:	FARGO
State	:	ND
Zip	:	58103-1030
Country	:	US
Telephone Number	:	267-665-8611
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. ZEDUEH ALBERT DOERUE
Credential	:
Telephone Number	:	267-665-8611

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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