Provider Demographics
NPI:1467788026
Name:TENDER MERCIES, INC 1
Entity Type:Organization
Organization Name:TENDER MERCIES, INC 1
Other - Org Name:TENDER MERCIES, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:O
Authorized Official - Last Name:OLANREWAJU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-699-0125
Mailing Address - Street 1:1914 SHERRON RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8885
Mailing Address - Country:US
Mailing Address - Phone:919-699-0125
Mailing Address - Fax:919-767-9037
Practice Address - Street 1:3747 WAKE FOREST RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-3634
Practice Address - Country:US
Practice Address - Phone:919-699-0125
Practice Address - Fax:919-767-9037
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TENDER MERCIES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health