MEDICARE: TENDER TOUCH PRIVATE HOME CARE, 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	314000000X	Skilled Nursing Facility	RN184260	GA

General Provider Information

NPI Number	:	1669723987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDER TOUCH PRIVATE HOME CARE, LLC

Provider Business Mailing Address
First Line	:	215 HILLTOP DR SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30315-6019
Country	:	US
Telephone Number	:	678-634-9668
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 HILLTOP DR SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30315-6019
Country	:	US
Telephone Number	:	678-634-9668
Fax Number	:

Authorized Official
Title or Position	:	OWNER/RN
Name	:	MS. KETURAH W FRAZIER
Credential	:	RN
Telephone Number	:	678-634-9668

Provider Enumeration Date	:	09/26/2012
Last Update Date	:	09/26/2012

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