Healthcare Provider Details

I. General information

NPI: 1922439272
Provider Name (Legal Business Name): TENDERCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19300 WHERLE DR
BROWNSTOWN MI
48193-8530
US

IV. Provider business mailing address

22950 NORTHLINE RD
TAYLOR MI
48180-4696
US

V. Phone/Fax

Practice location:
  • Phone: 313-671-6231
  • Fax:
Mailing address:
  • Phone: 734-287-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateMI

VIII. Authorized Official

Name: MRS. KIMBERLY ANN HALL
Title or Position: CERTIFIED OCCUPATIONAL THERAPY ASST
Credential: COTA/L
Phone: 313-671-6231