Healthcare Provider Details

I. General information

NPI: 1356582647
Provider Name (Legal Business Name): TENDERCARE (MICHIGAN) INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2009
Last Update Date: 12/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5211 MARSH ROAD
OKEMOS MI
48864-1106
US

IV. Provider business mailing address

111 W MICHIGAN ST
MILWAUKEE WI
53203-2903
US

V. Phone/Fax

Practice location:
  • Phone: 517-930-1660
  • Fax: 810-231-0418
Mailing address:
  • Phone: 414-908-8119
  • Fax: 414-908-7105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. DONNA J MAASSEN
Title or Position: DIRECTOR OF COMPLIANCE
Credential:
Phone: 414-908-8119