Provider Demographics
NPI:1548723414
Name:TENDER LOVING CARE ADULT DAYCARE
Entity type:Organization
Organization Name:TENDER LOVING CARE ADULT DAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICATION TECHNICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLEE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-960-0077
Mailing Address - Street 1:6414 BRICKTOWN CIR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-1541
Mailing Address - Country:US
Mailing Address - Phone:443-960-0077
Mailing Address - Fax:
Practice Address - Street 1:6414 BRICKTOWN CIR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-1541
Practice Address - Country:US
Practice Address - Phone:443-960-0077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health