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TYSON HOME
NPI 1699850016
Intermediate Care Facility, Intellectual Disabilities in Vallejo, CA

Active since October 25, 2006
624 MINI DR, VALLEJO, CA 94589(707) 553-2798 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Tyson Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYSON HOME (NPI 1699850016) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Vallejo, California and active in the NPI registry since October 2006. The organization lists Elizabeth Kordovez Cuizon, Medi-cal Biller, as its authorized official.

NPPES Registry Identity

NPI1699850016
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameTYSON HOME
Location Address624 MINI DRVallejo, CA 94589-1735
Mailing AddressPo Box 1425Vallejo, CA 94590-0142 · (707) 333-2005
Phone(707) 553-2798
Organization SubpartNo
Authorized OfficialElizabeth Kordovez CuizonMedi-cal Biller · (707) 812-0080
Enumeration DateOctober 25, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1699850016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
624 MINI DR, Vallejo, CA 94589
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Other Identifiers 1

MedicaidLTC60826FCA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyson Home's NPI number?

The NPI number for Tyson Home is 1699850016. It was assigned to this organization in the NPPES registry on October 25, 2006.

Where is Tyson Home located?

Tyson Home is located at 624 Mini Dr, Vallejo, CA 94589. The listed phone number is (707) 553-2798.

What is Tyson Home's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Tyson Home was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.