Provider Demographics
NPI:1558022657
Name:TENDACARE LLC
Entity Type:Organization
Organization Name:TENDACARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATEMACHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-782-5509
Mailing Address - Street 1:3547 CAROLINE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-1027
Mailing Address - Country:US
Mailing Address - Phone:317-640-3881
Mailing Address - Fax:
Practice Address - Street 1:3547 CAROLINE AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-1027
Practice Address - Country:US
Practice Address - Phone:317-640-3881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)