Provider Demographics
NPI:1104060854
Name:TJ HOME SERVICES
Entity type:Organization
Organization Name:TJ HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DORBOR
Authorized Official - Last Name:FLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-644-5769
Mailing Address - Street 1:8015 36TH AVE N
Mailing Address - Street 2:#319
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427-1975
Mailing Address - Country:US
Mailing Address - Phone:612-644-5769
Mailing Address - Fax:
Practice Address - Street 1:8015 36TH AVE N
Practice Address - Street 2:#319
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427-1975
Practice Address - Country:US
Practice Address - Phone:612-644-5769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-25
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health