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General NPI Number Information
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NPI Number | 1265975387
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Entity Type | Organization
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Legal Business Name | TENDER LOVING COMPANION CARE LLC
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Dates
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Enumeration Date | 11/21/2016
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Last Update Date | 11/21/2016
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Provider Practice Location Address
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Address Line | 13104 SANCTUARY COVE DR UNIT 104
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City | TEMPLE TERRACE
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State | FL
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Zip | 33637-2161
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Country | US
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Telephone | 813-340-0173
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Fax |
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Provider Business Mailing Address
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Address Line | 13104 SANCTUARY COVE DR UNIT 104
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City | TEMPLE TERRACE
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State | FL
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Zip | 33637-2161
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Country | US
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Telephone | 813-340-0173
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Fax |
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Authorized Official
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Title or Position | OWNER/CNA
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Name | TYSNIE WILLIAMS
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Credential | CNA
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Telephone | 813-340-0173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | CNA307360
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License Number State | FL
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