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General NPI Number Information
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NPI Number | 1417565425
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Entity Type | Organization
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Legal Business Name | TINY TOTS PEDIATRIC HOME HEALTH, LLC
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 08/14/2020
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Provider Practice Location Address
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Address Line | 11023 CAPE RISE TRL
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City | HOUSTON
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State | TX
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Zip | 77044-5990
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Country | US
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Telephone | 832-270-7948
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Fax |
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Provider Business Mailing Address
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Address Line | 13165 W LAKE HOUSTON PKWY STE 211
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City | HOUSTON
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State | TX
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Zip | 77044-5391
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Country | US
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Telephone | 832-270-7948
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TIFFANY JACKSON
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Credential |
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Telephone | 832-270-7948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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