Provider Demographics
NPI:1003357567
Name:TENDER CARE INC AT WESTFORD DRIVE
Entity Type:Organization
Organization Name:TENDER CARE INC AT WESTFORD DRIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOTLYN
Authorized Official - Middle Name:SALOME
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:321-303-4907
Mailing Address - Street 1:3410 WESTFORD DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-5647
Mailing Address - Country:US
Mailing Address - Phone:321-303-4907
Mailing Address - Fax:407-523-3798
Practice Address - Street 1:3410 WESTFORD DR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-5647
Practice Address - Country:US
Practice Address - Phone:321-303-4907
Practice Address - Fax:407-523-3798
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TENDER CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness