Provider Demographics
NPI:1427002591
Name:TENDER LOVING CARE HEALTH CARE SERVICES OF DADE, LLC
Entity Type:Organization
Organization Name:TENDER LOVING CARE HEALTH CARE SERVICES OF DADE, LLC
Other - Org Name:STAFF BUILDERS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-298-3548
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:15495 EAGLE NEST LN
Practice Address - Street 2:STE 260
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2242
Practice Address - Country:US
Practice Address - Phone:305-365-2050
Practice Address - Fax:305-822-9415
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TLC HEALTH CARE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-21
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2113096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL201031840003OtherTRICARE HUMANA
FL651112900Medicaid
FL107129OtherHUMANA PPS
FL651112900Medicaid