Healthcare Provider Details

I. General information

NPI: 1053487041
Provider Name (Legal Business Name): TENDER CARE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 COOPER RUN DR COOPER RUN DRIVE
CHERRY HILL NJ
08003-2244
US

IV. Provider business mailing address

29 COOPER RUN DR COOPER RUN DRIVE
CHERRY HILL NJ
08003-2244
US

V. Phone/Fax

Practice location:
  • Phone: 856-424-8711
  • Fax: 856-424-8711
Mailing address:
  • Phone: 856-424-8711
  • Fax: 856-424-8711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number26NR07153400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0097500
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNJ

VIII. Authorized Official

Name: MRS. JULIETTE KERSAINT
Title or Position: ACCOUNT MANAGER
Credential: RN
Phone: 856-424-8711