Provider Demographics
NPI:1215220256
Name:TATIANA'S HOME CARE, LLC
Entity type:Organization
Organization Name:TATIANA'S HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TATIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILDRED
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:937-241-4417
Mailing Address - Street 1:3220 BEAVER VU DR STE 110
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-6400
Mailing Address - Country:US
Mailing Address - Phone:937-228-0811
Mailing Address - Fax:937-228-0886
Practice Address - Street 1:3220 BEAVER VU DR STE 110
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-6400
Practice Address - Country:US
Practice Address - Phone:937-241-4417
Practice Address - Fax:937-241-4417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities