Provider Demographics
NPI:1871153064
Name:TAHOLAND CARE & ASSOCIATES, LLC
Entity type:Organization
Organization Name:TAHOLAND CARE & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERGEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-312-4845
Mailing Address - Street 1:1615 NW 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-2204
Mailing Address - Country:US
Mailing Address - Phone:786-312-4845
Mailing Address - Fax:
Practice Address - Street 1:27407 SW 143RD AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-8866
Practice Address - Country:US
Practice Address - Phone:786-312-4845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health