Provider Demographics
NPI:1477202059
Name:TEND 2 OTHERS ENDEPENDENCE
Entity Type:Organization
Organization Name:TEND 2 OTHERS ENDEPENDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:KOURTNESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DODD
Authorized Official - Phone:513-496-7115
Mailing Address - Street 1:3731 BORDEN ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-2310
Mailing Address - Country:US
Mailing Address - Phone:513-496-7115
Mailing Address - Fax:
Practice Address - Street 1:3731 BORDEN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223-2310
Practice Address - Country:US
Practice Address - Phone:513-496-7115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3125123OtherCONTRACT NUMBER