Provider Demographics
NPI:1326214552
Name:TENDER LOVE AND CARE INDEPENDENT LIVING SERVICES LLC
Entity Type:Organization
Organization Name:TENDER LOVE AND CARE INDEPENDENT LIVING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BUGGAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-932-9888
Mailing Address - Street 1:PO BOX 54366
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70892-4366
Mailing Address - Country:US
Mailing Address - Phone:225-932-9888
Mailing Address - Fax:225-932-9880
Practice Address - Street 1:1926 WOODDALE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1539
Practice Address - Country:US
Practice Address - Phone:225-932-9888
Practice Address - Fax:225-932-9880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1509434Medicaid