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General NPI Number Information
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NPI Number | 1245270511
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Entity Type | Organization
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Legal Business Name | TENDER LOVING CARE HEALTH CARE SERVICES MIDWEST, LLC
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 03/03/2014
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Provider Practice Location Address
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Address Line | 1230 E DIEHL RD SUITE 202
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City | NAPERVILLE
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State | IL
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Zip | 60563-9353
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Country | US
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Telephone | 630-505-4275
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Fax | 630-505-7370
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Provider Business Mailing Address
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Address Line | 5959 S SHERWOOD FOREST BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-6038
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Country | US
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Telephone | 225-292-2031
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Fax | 225-295-9678
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RONALD LABORDE
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Credential |
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Telephone | 225-292-2031
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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 | 1010376
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License Number State | IL
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