Provider Demographics
NPI:1033762042
Name:A&D TENDER LOVING CARE
Entity Type:Organization
Organization Name:A&D TENDER LOVING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DERONVIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-235-8494
Mailing Address - Street 1:150 NE 18TH ST
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060-5256
Mailing Address - Country:US
Mailing Address - Phone:954-785-9311
Mailing Address - Fax:
Practice Address - Street 1:150 NE 18TH ST
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-5256
Practice Address - Country:US
Practice Address - Phone:954-785-9311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility