MEDICARE: TENDER CARE HOME FOR ADULTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	114288	TX

General Provider Information

NPI Number	:	1528255650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDER CARE HOME FOR ADULTS

Provider Business Mailing Address
First Line	:	3600 CHAMBERLAND DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-3118
Country	:	US
Telephone Number	:	817-800-9948
Fax Number	:	817-557-5434

Provider Business Practice Location Address
First Line	:	3600 CHAMBERLAND DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-3118
Country	:	US
Telephone Number	:	817-800-9948
Fax Number	:	817-557-5434

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. BOLA M ONI
Credential	:
Telephone Number	:	817-800-9948

Provider Enumeration Date	:	10/02/2007
Last Update Date	:	10/02/2007

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