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General NPI Number Information
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NPI Number | 1700210440
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Entity Type | Organization
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Legal Business Name | TENDER LOVING CARE ASSISTED LIVING
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 08/29/2013
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Provider Practice Location Address
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Address Line | 2250 W.EUCLID
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City | DETROIT
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State | MI
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Zip | 48206
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Country | US
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Telephone | 131-336-1595
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 W EUCLID ST
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City | DETROIT
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State | MI
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Zip | 48206-2403
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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 | ADMINISTRATOR
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Name | MS. SHEILA LATRICE RHODES
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Credential | MASTERS DEGREE
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Telephone | 13133615955
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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 | AS820321872
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License Number State | MI
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