Healthcare Provider Details

I. General information

NPI: 1023675279
Provider Name (Legal Business Name): TAMMY'S TENDER CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 05/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 BERLIN RD APT 310
HURON OH
44839-1989
US

IV. Provider business mailing address

512 BERLIN RD APT 310
HURON OH
44839-1989
US

V. Phone/Fax

Practice location:
  • Phone: 419-616-3136
  • Fax:
Mailing address:
  • Phone: 419-616-3136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TAMMY A JOCKE
Title or Position: OWNER
Credential:
Phone: 216-415-1360