Provider Demographics
NPI:1114662657
Name:OUTLAW TENDER TOUCH HOME CARE
Entity Type:Organization
Organization Name:OUTLAW TENDER TOUCH HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:TAMEKA
Authorized Official - Last Name:SOLOMON-OUTLAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-624-6304
Mailing Address - Street 1:PO BOX 872
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-0872
Mailing Address - Country:US
Mailing Address - Phone:267-624-6304
Mailing Address - Fax:610-424-3253
Practice Address - Street 1:241 CAMBRIDGE ROAD
Practice Address - Street 2:
Practice Address - City:CLIFTON HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:19018
Practice Address - Country:US
Practice Address - Phone:610-609-7076
Practice Address - Fax:610-424-3253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care