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General NPI Number Information
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NPI Number | 1720265424
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Entity Type | Organization
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Legal Business Name | TENDER LOVING CARE PROVIDERS, INC.
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Dates
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Enumeration Date | 01/24/2008
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 6494 N. W. GROVELAND TERRACE
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City | PORT ST. LUCIE
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State | FL
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Zip | 34986-3825
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Country | US
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Telephone | 561-644-4283
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Fax |
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Provider Business Mailing Address
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Address Line | 6494 N. W. GROVELAND TERRACE
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City | PORT ST. LUCIE
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State | FL
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Zip | 34986-3825
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Country | US
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Telephone | 561-644-4283
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Fax |
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Authorized Official
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Title or Position | LICENSED PRACTICAL NURSE
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Name | MRS. BRIDGETTE ANNETTA HARRIS
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Credential |
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Telephone | 561-644-4283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | PN1068941
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | PN1068941
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | PN1068941
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PN1068941
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | PN1068941
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | PN1068941
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License Number State | FL
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Taxonomy #8
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | PN1068941
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License Number State | FL
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