Provider Demographics
NPI:1902974470
Name:TLAY HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:TLAY HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TITILAYO
Authorized Official - Middle Name:ADENIKE
Authorized Official - Last Name:UNEGBU
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MBA
Authorized Official - Phone:904-794-7601
Mailing Address - Street 1:2744 US HIGHWAY 1 S
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-6336
Mailing Address - Country:US
Mailing Address - Phone:904-794-7601
Mailing Address - Fax:904-794-7602
Practice Address - Street 1:2744 US HIGHWAY 1 S
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-6336
Practice Address - Country:US
Practice Address - Phone:904-794-7601
Practice Address - Fax:904-794-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health