Provider Demographics
NPI:1285407163
Name:TBF HOME HEALTH LLC
Entity type:Organization
Organization Name:TBF HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAKALA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-548-0927
Mailing Address - Street 1:2916 CENTRAL ST FL 2
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1212
Mailing Address - Country:US
Mailing Address - Phone:224-548-0927
Mailing Address - Fax:847-556-6544
Practice Address - Street 1:2916 CENTRAL ST FL 2
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1212
Practice Address - Country:US
Practice Address - Phone:224-548-0927
Practice Address - Fax:847-556-6544
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TBF HOME HEALTH AGENCY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-02
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care