Provider Demographics
NPI:1003288135
Name:PENDLOVE INC
Entity Type:Organization
Organization Name:PENDLOVE INC
Other - Org Name:PENDLETON HOUSE OF LOVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MACAUTHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-744-6327
Mailing Address - Street 1:1934 PENDLETON ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38114-4952
Mailing Address - Country:US
Mailing Address - Phone:901-744-6327
Mailing Address - Fax:901-745-2749
Practice Address - Street 1:1934 PENDLETON ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38114-4952
Practice Address - Country:US
Practice Address - Phone:901-744-6327
Practice Address - Fax:901-745-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00185311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility