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General NPI Number Information
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NPI Number | 1841528379
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Entity Type | Organization
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Legal Business Name | TENDERCARE PROFESSIONAL ASSISTED LIVING SERVICES, INC.
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 11/20/2009
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Provider Practice Location Address
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Address Line | 1150 LOUISIANA AVE SUITE 5C
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City | WINTER PARK
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State | FL
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Zip | 32789-2354
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Country | US
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Telephone | 407-599-1900
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Fax | 407-599-1903
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Provider Business Mailing Address
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Address Line | PO BOX 1542
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City | WINTER PARK
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State | FL
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Zip | 32790-1542
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Country | US
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Telephone | 407-599-1900
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Fax | 407-599-1903
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. NANCY R. BLAND
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Credential |
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Telephone | 407-599-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | NR3014096
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License Number State | FL
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