Provider Demographics
NPI:1578196523
Name:TENDER HEART SUPPORTIVE SERVICES
Entity Type:Organization
Organization Name:TENDER HEART SUPPORTIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:OLUBUKOLA
Authorized Official - Last Name:KEHINDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-517-9271
Mailing Address - Street 1:12 VILLAGE GATE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-4402
Mailing Address - Country:US
Mailing Address - Phone:973-517-9271
Mailing Address - Fax:908-223-1833
Practice Address - Street 1:12 VILLAGE GATE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07882-4402
Practice Address - Country:US
Practice Address - Phone:973-517-9271
Practice Address - Fax:908-223-1833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251X00000XAgenciesSupports Brokerage
No385H00000XRespite Care FacilityRespite Care