Provider Demographics
NPI:1144541640
Name:TALLAHASSEE SENIOR CARE, LLC
Entity type:Organization
Organization Name:TALLAHASSEE SENIOR CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BROOKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-597-8304
Mailing Address - Street 1:2236 CAPITAL CIR NE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-8305
Mailing Address - Country:US
Mailing Address - Phone:850-597-8304
Mailing Address - Fax:
Practice Address - Street 1:2236 CAPITAL CIR NE
Practice Address - Street 2:SUITE 101
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-8305
Practice Address - Country:US
Practice Address - Phone:850-597-8304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROOKINS ELDERSERVE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-18
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health