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General NPI Number Information
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NPI Number | 1598700403
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Entity Type | Organization
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Legal Business Name | TENDERCARE SELECT PROPERTIES INC.
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 508 RANDOM LN RTE. 4
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City | GAYLORD
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State | MI
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Zip | 49735-9304
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Country | US
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Telephone | 989-732-3508
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Fax | 989-731-5260
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Provider Business Mailing Address
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Address Line | 209 E PORTAGE AVE
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City | SAULT SAINTE MARIE
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State | MI
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Zip | 49783-4200
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Country | US
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Telephone | 906-635-0020
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Fax | 906-635-0212
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Authorized Official
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Title or Position | PRIVACY OFFICER
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Name | MS. DONNA J MAASSEN
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Credential |
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Telephone | 414-908-8119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 694020
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License Number State | MI
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