Provider Demographics
NPI:1518305432
Name:TENDER LOVING PERSONAL CARE, LLP
Entity Type:Organization
Organization Name:TENDER LOVING PERSONAL CARE, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFINNE
Authorized Official - Middle Name:D
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSM
Authorized Official - Phone:414-628-0491
Mailing Address - Street 1:3914 N 65TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2116
Mailing Address - Country:US
Mailing Address - Phone:414-628-0491
Mailing Address - Fax:
Practice Address - Street 1:3914 N 65TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2116
Practice Address - Country:US
Practice Address - Phone:414-628-0491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100029879Medicaid