Healthcare Provider Details

I. General information

NPI: 1386641819
Provider Name (Legal Business Name): TENDA GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 N JACKSON ST
SALEM MO
65560-1076
US

IV. Provider business mailing address

312 SOLLEY DR
BALLWIN MO
63021-5248
US

V. Phone/Fax

Practice location:
  • Phone: 573-729-6640
  • Fax: 573-729-7694
Mailing address:
  • Phone: 636-394-3000
  • Fax: 636-394-7713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number033710
License Number StateMO

VIII. Authorized Official

Name: JAMES GIARDINA
Title or Position: PRESIDENT
Credential:
Phone: 636-394-3000