Provider Demographics
NPI:1104040245
Name:TENDER LOVING CARE PROFESSIONAL ADULT SITTING SERVICE INC.
Entity Type:Organization
Organization Name:TENDER LOVING CARE PROFESSIONAL ADULT SITTING SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIDGETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-392-2291
Mailing Address - Street 1:6207 GENERAL MEYER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-2015
Mailing Address - Country:US
Mailing Address - Phone:504-392-2291
Mailing Address - Fax:504-392-2271
Practice Address - Street 1:5163 GENERAL DEGAULLE DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-7262
Practice Address - Country:US
Practice Address - Phone:504-392-2291
Practice Address - Fax:504-392-2271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LASIL 10746251E00000X
LAPCA 10745251E00000X
LARC 12015251E00000X
LASIL 12584251E00000X
LAPCA 12583251E00000X
LAPCA 17030251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1196410Medicaid