Provider Demographics
NPI:1376215392
Name:TENDER HEARTS HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:TENDER HEARTS HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:WALKER-PAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-937-4042
Mailing Address - Street 1:1 OLYMPIC PL STE 900
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4113
Mailing Address - Country:US
Mailing Address - Phone:667-205-2103
Mailing Address - Fax:667-777-1996
Practice Address - Street 1:1 OLYMPIC PL STE 900
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4113
Practice Address - Country:US
Practice Address - Phone:667-205-2103
Practice Address - Fax:667-777-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA00024822OtherCERTIFIED NURSING ASSISTANT