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Organization
TALLACARE HEALTH AND WELLNESS SERVICES LLC
Active
Organization
TALLACARE HEALTH AND WELLNESS SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORANTIN TALLA (CEO)
(301) 910-4090
Entity
Organization
Contact information
Practice address
3205 LUCIA WAY, PRINCETON, TX 75407-3427
(301) 910-4090
Mailing address
3205 LUCIA WAY, PRINCETON, TX 75407-3427
(301) 910-4090
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
103TH0100X
Health Service Psychologist
—
NULL
103TH0100X
Health Service Psychologist
—
—
163WH0200X
Home Health Registered Nurse
Primary
—
NULL
163WH0200X
Home Health Registered Nurse
Primary
—
—
364SH0200X
Home Health Clinical Nurse Specialist
—
NULL
364SH0200X
Home Health Clinical Nurse Specialist
—
—
Other
Enumeration date
12/10/2025
Last updated
12/10/2025
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