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General NPI Number Information
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NPI Number | 1013351451
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Entity Type | Organization
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Legal Business Name | TANYA IN HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 04/27/2013
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Last Update Date | 06/03/2013
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Provider Practice Location Address
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Address Line | 11400 W OLYMPIC BLVD 200
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City | LOS ANGELES
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State | CA
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Zip | 90064-1550
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Country | US
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Telephone | 323-445-8856
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Fax | 323-296-0368
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Provider Business Mailing Address
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Address Line | 11400 W OLYMPIC BLVD 200
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City | LOS ANGELES
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State | CA
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Zip | 90064-1550
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Country | US
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Telephone | 323-445-8856
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Fax | 323-296-0368
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Authorized Official
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Title or Position | NURSE
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Name | MRS. TANYA DENISE TILLETT
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Credential | CNA
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Telephone | 323-868-8116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | CA
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