Healthcare Provider Details

I. General information

NPI: 1639118987
Provider Name (Legal Business Name): TENDER LOVING CARE HEALTH CARE SERVICES OF BROWARD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3323 W. COMMERCIAL BOULEVARD SUITE 100
FT. LAUDERDALE FL
33309-3456
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 954-486-5506
  • Fax: 954-739-5129
Mailing address:
  • Phone: 225-292-2031
  • Fax: 225-295-9678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number21128096
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number21128096
License Number StateFL

VIII. Authorized Official

Name: MR. WILLIAM F BORNE
Title or Position: CEO
Credential:
Phone: 225-292-2031