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General NPI Number Information
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NPI Number | 1225726367
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Entity Type | Organization
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Legal Business Name | TENDER LOVING MEMORY CARE & ASSISTED LIVING HOME LLC
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Dates
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Enumeration Date | 04/26/2023
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 3429 W LONE MOUNTAIN RD
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-2239
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Country | US
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Telephone | 626-231-1353
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Fax |
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Provider Business Mailing Address
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Address Line | 3429 W LONE MOUNTAIN RD
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89031-2239
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANGING MEMBER
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Name | LEO WONG
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Credential |
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Telephone | 626-231-1353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State |
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