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NPI 1215470430

NPI 1215470430 : TENDER MOMENTS HOME CARE, LLC : PHILADELPHIA, PA

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General NPI Number Information
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    NPI Number           |    1215470430
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    Entity Type          |    Organization 
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    Legal Business Name  |    TENDER MOMENTS HOME CARE, LLC 
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Dates
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    Enumeration Date     |    11/19/2016
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    Last Update Date     |    11/19/2016
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Provider Practice Location Address
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    Address Line         |    1708 ELSTON ST 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19126-1521
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    Country              |    US
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    Telephone            |    267-443-0955
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1708 ELSTON ST 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19126-1521
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    Country              |    US
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    Telephone            |    267-443-0955
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     KELLI  EDMONDS 
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    Credential           |    
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    Telephone            |    267-443-0955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    31363601
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    License Number State |    PA
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