Provider Demographics
NPI:1003368036
Name:TENDER HANDS PRIVATE HOMECARE INC
Entity Type:Organization
Organization Name:TENDER HANDS PRIVATE HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLERY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-308-9914
Mailing Address - Street 1:310 BRITTNEY CV
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-6937
Mailing Address - Country:US
Mailing Address - Phone:678-308-9914
Mailing Address - Fax:678-786-2037
Practice Address - Street 1:461 W CROGAN ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4735
Practice Address - Country:US
Practice Address - Phone:470-299-2090
Practice Address - Fax:678-786-2037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251E00000X, 253Z00000X, 372600000X, 3747A0650X, 3747P1801X, 374U00000X, 376J00000X, 376K00000X
251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No251J00000XAgenciesNursing CareGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003187549AMedicaid