MEDICARE: TENDER LOVING CARE HEALTH CARE SERVICES OF BROWARD, 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	251B00000X	Case Management Agency	21128096	FL
2	251E00000X	Home Health Agency	21128096	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	J93	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1639118987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDER LOVING CARE HEALTH CARE SERVICES OF BROWARD, LLC

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	225-292-2031
Fax Number	:	225-295-9678

Provider Business Practice Location Address
First Line	:	3323 W. COMMERCIAL BOULEVARD
Second Line	:	SUITE 100
City	:	FT. LAUDERDALE
State	:	FL
Zip	:	33309-3456
Country	:	US
Telephone Number	:	954-486-5506
Fax Number	:	954-739-5129

Authorized Official
Title or Position	:	CEO
Name	:	MR. WILLIAM F BORNE
Credential	:
Telephone Number	:	225-292-2031

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	12/18/2009

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