Provider Demographics
NPI:1538687280
Name:TKS CARE SERVICES, INC
Entity type:Organization
Organization Name:TKS CARE SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:PHELAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-290-7766
Mailing Address - Street 1:1416 CLOVIS AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-2700
Mailing Address - Country:US
Mailing Address - Phone:559-224-5678
Mailing Address - Fax:559-224-5670
Practice Address - Street 1:1416 CLOVIS AVE STE 208
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-2700
Practice Address - Country:US
Practice Address - Phone:559-224-5678
Practice Address - Fax:559-224-5670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104700019253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA104700019OtherHOME CARE ORGANIZATION NUMBER