Healthcare Provider Details

I. General information

NPI: 1770398299
Provider Name (Legal Business Name): TENDERCARE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 AVONWOOD RD APT 103
AVON CT
06001-2010
US

IV. Provider business mailing address

47 AVONWOOD RD APT 103
AVON CT
06001-2010
US

V. Phone/Fax

Practice location:
  • Phone: 959-221-8496
  • Fax:
Mailing address:
  • Phone: 959-221-8496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMMY MAINA
Title or Position: DIRECTOR
Credential:
Phone: 959-221-8496