MEDICARE: TENDER HEART HEALTH SERVICES LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1578022638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDER HEART HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	25814 ELMLEY PL
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-3490
Country	:	US
Telephone Number	:	512-751-0588
Fax Number	:

Provider Business Practice Location Address
First Line	:	25814 ELMLEY PL
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-3490
Country	:	US
Telephone Number	:	512-751-0588
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	RENAE SHORTS
Credential	:
Telephone Number	:	512-751-0588

Provider Enumeration Date	:	03/18/2019
Last Update Date	:	03/18/2019

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