TDAL HOME CARE LLC (NPI# 1851861991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851861991 |
| Entity Type | Organization |
| Organization Name | TDAL HOME CARE LLC |
| Practice Address |
19510 Burlington Dr Detroit MI 48203-1454 |
| Practice Telephone | 3134617836 |
| Mailing Telephone | 3134617836 |
| Enumeration Date | 2018-12-02 |
| Last Update Date | 2018-12-02 |
| Authorized Official Name | MR. HAROLD BRAGGS JR. (PRESIDENT) |
| Authorized Official Telephone | 3134617836 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers | ||
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE ID | 802224649 | 01 |
| Street Address |
19510 BURLINGTON DR |
| City | DETROIT |
| State | MI |
| Zip Code | 48203-1454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992355135 | James Calloway | Peer Specialist | 1211 E Mcnichols, Detroit, MI 48203 | 2019-09-19 |
| 1851868582 | Community Veterans Services Inc | Counselor | 163 Tennyson, Highland Park, MI 48203 | 2018-10-31 |
| 1346601838 | Rainbow Center of Michigan | Health Maintenance Organization | 12501 Hamilton Ave., Highland Park, MI 48203 | 2016-03-11 |
| 1134502354 | Minds Moving In New Directions Inc | Community/Behavioral Health | 62 Massachusetts St, Highland Park, MI 48203 | 2015-07-07 |
| 1811312937 | Brea Holloway | Home Health | 20249 Yacama Rd, Detroit, MI 48203 | 2014-02-26 |
| 1770821795 | St John Providence Health Systems | Community/Behavioral Health | 1150 Lantz St, Detroit, MI 48203 | 2013-01-25 |
| 1871845412 | Waneta Darcell Dickerson | Social Worker | 169 W. Buena Vista, Highlandpark, MI 48203 | 2012-10-05 |
| 1629331939 | Maureen Connolly | Pediatrics | 77 Victor St, Highland Park, MI 48203 | 2012-06-21 |
| 1578850251 | Detroit Recovery Project | Community/Behavioral Health | 1121 East Mc Nichols, Detroit, MI 48203 | 2011-07-01 |
| 1265728414 | Barbara Suzanne Tyson | Home Health | 301 Glendale St, Apt B8, Highland Park, MI 48203 | 2011-06-27 |
| Find all providers in zip 48203 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376187476 | Sarda Charlotte Owens | Technician | 3502 Stockton St, Detroit, MI 48234-1735 | 2019-10-31 |
| 1720634934 | Brenda Roberts | Technician | 5906 Harrell St, Detroit, MI 48213-3534 | 2019-08-13 |
| 1992286108 | Jazmine Martin | Technician | 3501 Woodward Ave, Detroit, MI 48201-2441 | 2018-08-25 |
| 1326417494 | Onia Lee Pilgrim | Technician | 2263 Edison Street, Detroit, MI 48206-2042 | 2015-09-18 |
| 1669023057 | Latoya Nicole Cosey | Technician | 4401 Conner St, Detroit, MI 48215-2201 | 2019-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164021028 | Jaharie Green | Technician | 235 Arbor Glen Dr, East Lansing, MI 48823-8459 | 2020-10-21 |
| 1265030555 | Lauren Alexa Remijan | Technician | 18250 Queensbury Dr, Livonia, MI 48152-3946 | 2020-10-09 |
| 1346857067 | Nicholas Luke Roman | Technician | 10452 Lodge Dr, Allendale, MI 49401-9395 | 2020-09-27 |
| 1346856242 | Marissa Jean Brandly | Technician | 768 W Castlebury Cir, Saline, MI 48176-1348 | 2020-09-17 |
| 1962016030 | Stephanie Pertchi | Technician | 10745 48th Ave Unit Q3, Allendale, MI 49401-8127 | 2020-09-04 |
| 1356954705 | Mckenna Shank | Technician | 1409 E Beltline Ave Se, Grand Rapids, MI 49506 | 2020-08-26 |
| 1477166924 | Whispering Pines 2 | Technician | 1878 Soules Rd, Afton, MI 49705-9717 | 2020-08-25 |
| 1659983062 | Serena Selwyn | Technician | 2024 Edgewood Ave Se, Grand Rapids, MI 49546-5718 | 2020-08-18 |
| 1780293043 | Alyn Kristin Kay | Technician | Hope Network-hope's Door Cru, 3699 Miles Rd., Jackson, MI 49201 | 2020-07-23 |
| 1285242420 | Anna Therese Pignone | Technician | 918 E Grand River Ave Apt 718, East Lansing, MI 48823-4597 | 2020-07-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.