Healthcare Provider Details

I. General information

NPI: 1578196523
Provider Name (Legal Business Name): TENDER HEART SUPPORTIVE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 VILLAGE GATE RD
WASHINGTON NJ
07882-4402
US

IV. Provider business mailing address

12 VILLAGE GATE RD
WASHINGTON NJ
07882-4402
US

V. Phone/Fax

Practice location:
  • Phone: 973-517-9271
  • Fax: 908-223-1833
Mailing address:
  • Phone: 973-517-9271
  • Fax: 908-223-1833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. HELEN OLUBUKOLA KEHINDE
Title or Position: DIRECTOR
Credential:
Phone: 973-517-9271