Provider Demographics
NPI:1407464274
Name:TOMLEEN COMPLETE CARE INC.
Entity type:Organization
Organization Name:TOMLEEN COMPLETE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MISS
Authorized Official - First Name:TOMMY GAY
Authorized Official - Middle Name:ANESHA
Authorized Official - Last Name:MOYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-729-8612
Mailing Address - Street 1:4281 MANGO BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-9176
Mailing Address - Country:US
Mailing Address - Phone:561-729-8612
Mailing Address - Fax:561-328-3330
Practice Address - Street 1:4281 MANGO BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-9176
Practice Address - Country:US
Practice Address - Phone:561-729-8612
Practice Address - Fax:561-328-3330
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOMLEEN COMPLEDTE CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty