Provider Demographics
NPI:1154682326
Name:TENDER CARE ADULT CENTER
Entity Type:Organization
Organization Name:TENDER CARE ADULT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:NATALIE
Authorized Official - Last Name:JEUDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-265-2875
Mailing Address - Street 1:1102 BLUE HILL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-3108
Mailing Address - Country:US
Mailing Address - Phone:617-265-2875
Mailing Address - Fax:617-265-0146
Practice Address - Street 1:1102 BLUE HILL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124-3108
Practice Address - Country:US
Practice Address - Phone:617-265-2875
Practice Address - Fax:617-265-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care