Provider Demographics
NPI:1104237155
Name:TAPAWINGO FARMS
Entity type:Organization
Organization Name:TAPAWINGO FARMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BECKETT
Authorized Official - Suffix:
Authorized Official - Credentials:BSBA
Authorized Official - Phone:906-322-6381
Mailing Address - Street 1:965 E 3 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-9315
Mailing Address - Country:US
Mailing Address - Phone:906-322-6381
Mailing Address - Fax:
Practice Address - Street 1:965 E 3 MILE RD
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-9315
Practice Address - Country:US
Practice Address - Phone:906-322-6381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable