TYLYCE FARMS
NPI 1205424405
Home Health in Los Angeles, CA

Active since January 05, 2021
1937 E 111TH ST, LOS ANGELES, CA 90059(661) 797-4018 Get Directions Write a Review

NPPES record last updated: January 5, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Home Health

About TYLYCE FARMS

This page provides the complete NPI Profile along with additional information for Tylyce Farms, a provider established in Los Angeles, California operating as a Home Health. The healthcare provider is registered in the NPI registry with number 1205424405 assigned on January 2021. The practitioner's primary taxonomy code is 251E00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Tylyce Farms operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Charde Petrus Dsd (Director)

NPI
1205424405 Verify this NPI
Provider Name
TYLYCE FARMS
Entity Type
Organization
Location Address
1937 E 111TH ST LOS ANGELES, CA 90059
Location Phone
(661) 797-4018
Mailing Address
3231 KEY LARGO DR APT 202 LAS VEGAS, NV 89120
Mailing Phone
(925) 332-8810
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
01-05-2021
Last Update Date
01-05-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Home Health

Taxonomy Code
251E00000X
Type
Agencies
Taxonomy Description
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1101YA0400XBehavioral Health & Social Service Providers

Counselor
Addiction (Substance Use Disorder)

 
2167G00000XNursing Service Providers

Licensed Psychiatric Technician

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

CHARDE PETRUS DSD

Authorized Official Title
DIRECTOR
Authorized Official Phone
(661) 797-4018

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205424405, enumerated as an "organization" on January 05, 2021.

The provider is located at 1937 E 111TH ST LOS ANGELES, CA 90059 and the phone number is (661) 797-4018.

Home Health with taxonomy code 251E00000X.