Provider Demographics
NPI:1073150470
Name:TRUE TENDER LOVING CARE ADULT FOSTERING LLC
Entity Type:Organization
Organization Name:TRUE TENDER LOVING CARE ADULT FOSTERING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHARLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-459-8679
Mailing Address - Street 1:3407 DOLORES AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48091-1689
Mailing Address - Country:US
Mailing Address - Phone:586-459-8679
Mailing Address - Fax:
Practice Address - Street 1:3407 DOLORES AVE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48091-1689
Practice Address - Country:US
Practice Address - Phone:586-459-8679
Practice Address - Fax:586-393-1548
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRUE TENDER LOVING CARE ADULT FOSTERING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care