Healthcare Provider Details

I. General information

NPI: 1003543737
Provider Name (Legal Business Name): TENDRA HOME HEALTH , INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8569 PINES BLVD STE 209
PEMBROKE PINES FL
33024-6620
US

IV. Provider business mailing address

8569 PINES BLVD STE 209
PEMBROKE PINES FL
33024-6620
US

V. Phone/Fax

Practice location:
  • Phone: 866-919-3240
  • Fax: 877-300-7394
Mailing address:
  • Phone: 866-919-3240
  • Fax: 877-300-7394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KELLY KASKAVAGE
Title or Position: DIRECTOR OF COMPLIANCE
Credential:
Phone: 214-575-2999