Individual ProviderDetria TateCommunity/Behavioral HealthAgenciesPractice Address830 N Summit St, Toledo, OH 43604-1884(419) 693-9600PECOS EnrollmentBased on the most recent information from CMS, provider Detria Tate does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:34 AM.Profile DetailsProvider ID1851890255Provider TypeIndividualFull NameTate, DetriaGenderFemaleSole ProprietorYesEnumeration Date2/12/2018Last Updated7/21/2022Contact InformationPractice LocationPractice Address830 N Summit St, Toledo, OH 43604-1884Phone(419) 693-9600FaxUnlisted FaxMailing LocationMailing Address830 N Summit St, Toledo, OH 43604-1884Phone(419) 693-9600FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode251S00000XPrimaryDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted Issuer