Provider Demographics
NPI:1730552019
Name:TJ HEALTH CARE, LLC
Entity type:Organization
Organization Name:TJ HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMBENA
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BASSEKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-412-0498
Mailing Address - Street 1:5747 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CTRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55428
Mailing Address - Country:US
Mailing Address - Phone:763-537-1342
Mailing Address - Fax:763-537-1342
Practice Address - Street 1:5747 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55428-3549
Practice Address - Country:US
Practice Address - Phone:763-537-1342
Practice Address - Fax:763-537-1342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health