Provider Demographics
NPI:1437470655
Name:TENDER LOVING CARE SERVICES MIDWEST, LLC
Entity Type:Organization
Organization Name:TENDER LOVING CARE SERVICES MIDWEST, LLC
Other - Org Name:AMEDISYS HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLAIM
Authorized Official - Middle Name:F
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 1:4920 E STATE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2272
Practice Address - Country:US
Practice Address - Phone:815-229-2605
Practice Address - Fax:815-229-2947
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TENDER LOVING CARE SERVICES MIDWEST, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010376251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2001032204001Medicaid
IL2001032204001Medicaid