Healthcare Provider Details

I. General information

NPI: 1154682326
Provider Name (Legal Business Name): TENDER CARE ADULT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 06/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 BLUE HILL AVE SUITE A
DORCHESTER MA
02124-3108
US

IV. Provider business mailing address

1102 BLUE HILL AVE SUITE A
DORCHESTER MA
02124-3108
US

V. Phone/Fax

Practice location:
  • Phone: 617-265-2875
  • Fax: 617-265-0146
Mailing address:
  • Phone: 617-265-2875
  • Fax: 617-265-0146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SAMANTHA NATALIE JEUDY
Title or Position: OWNER
Credential:
Phone: 617-265-2875