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General NPI Number Information
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NPI Number | 1548412133
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Entity Type | Organization
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Legal Business Name | TENDER LOVING CARE HEALTH CARE SERVICES OF WEST VIRGINIA, L.L.C.
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Dates
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Enumeration Date | 10/15/2008
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Last Update Date | 05/06/2024
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Provider Practice Location Address
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Address Line | 300 WHARTON CIR STE 260
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City | TRIADELPHIA
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State | WV
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Zip | 26059-1293
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Country | US
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Telephone | 866-327-3204
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Fax | 866-588-1239
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Provider Business Mailing Address
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Address Line | 3854 AMERICAN WAY SUITE A
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City | BATON ROUGE
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State | LA
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Zip | 70816-4013
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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 | VP TAX
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Name | TRAVIS MIGLICCO
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Credential |
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Telephone | 225-299-3803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number | 19
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 19
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License Number State | WV
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