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General NPI Number Information
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NPI Number | 1871153064
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Entity Type | Organization
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Legal Business Name | TAHOLAND CARE & ASSOCIATES, LLC
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 27407 SW 143RD AVE
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City | HOMESTEAD
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State | FL
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Zip | 33032-8866
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Country | US
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Telephone | 786-312-4845
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Fax |
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Provider Business Mailing Address
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Address Line | 1615 NW 1ST AVE
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City | FLORIDA CITY
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State | FL
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Zip | 33034-2204
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Country | US
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Telephone | 786-312-4845
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS TANIA ROBERGEAU
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Credential |
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Telephone | 786-312-4845
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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 |
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