Provider Demographics
NPI:1053487041
Name:TENDER CARE HEALTH SERVICES
Entity Type:Organization
Organization Name:TENDER CARE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:KERSAINT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:856-424-8711
Mailing Address - Street 1:29 COOPER RUN DR
Mailing Address - Street 2:COOPER RUN DRIVE
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2244
Mailing Address - Country:US
Mailing Address - Phone:856-424-8711
Mailing Address - Fax:856-424-8711
Practice Address - Street 1:29 COOPER RUN DR
Practice Address - Street 2:COOPER RUN DRIVE
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2244
Practice Address - Country:US
Practice Address - Phone:856-424-8711
Practice Address - Fax:856-424-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR07153400251E00000X
NJHP0097500251E00000X
NJ163WH0200X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========Medicaid