Provider Demographics
NPI:1548376189
Name:TENDERTALES DISABILITY SERVICES, INC.
Entity type:Organization
Organization Name:TENDERTALES DISABILITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE FACILATATOR
Authorized Official - Prefix:
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKULAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-635-2425
Mailing Address - Street 1:PO BOX 2293
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-0046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:540-635-9629
Practice Address - Street 1:1137 HAPPY RIDGE DR
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-5302
Practice Address - Country:US
Practice Address - Phone:540-635-2425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management