Healthcare Provider Details

I. General information

NPI: 1871750018
Provider Name (Legal Business Name): TENDER CARE HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 CELEBRATION BLVD
FLORENCE SC
29501-5499
US

IV. Provider business mailing address

3005 VILLAGE PARK DR SUITE 204 B
KNIGHTDALE NC
27545-7993
US

V. Phone/Fax

Practice location:
  • Phone: 843-669-0104
  • Fax: 843-629-0325
Mailing address:
  • Phone: 843-669-0104
  • Fax: 843-629-0325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DARRELL KENYATTA TENNIE
Title or Position: ADMINISTRATOR
Credential:
Phone: 843-669-0104