Healthcare Provider Details

I. General information

NPI: 1134646110
Provider Name (Legal Business Name): TENNYSON HEALTH CARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2017
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6520 POE AVE STE 170
DAYTON OH
45414-2858
US

IV. Provider business mailing address

6520 POE AVE STE 170
DAYTON OH
45414-2858
US

V. Phone/Fax

Practice location:
  • Phone: 937-212-9834
  • Fax: 937-387-9356
Mailing address:
  • Phone: 937-387-9209
  • Fax: 937-836-2368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number011139
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number011139
License Number StateOH

VIII. Authorized Official

Name: MRS. SUSIE E DIBO NGALLE
Title or Position: PRESIDENT/CEO
Credential: BSDH, RDH
Phone: 937-212-9834