Provider Demographics
NPI:1598388795
Name:TENDER LOVING CARE
Entity Type:Organization
Organization Name:TENDER LOVING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-557-8341
Mailing Address - Street 1:167 KOEPSEL RD
Mailing Address - Street 2:
Mailing Address - City:MC QUEENEY
Mailing Address - State:TX
Mailing Address - Zip Code:78123-3535
Mailing Address - Country:US
Mailing Address - Phone:830-557-8341
Mailing Address - Fax:
Practice Address - Street 1:167 KOEPSEL RD
Practice Address - Street 2:
Practice Address - City:MC QUEENEY
Practice Address - State:TX
Practice Address - Zip Code:78123-3535
Practice Address - Country:US
Practice Address - Phone:830-557-8341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1255590428Medicaid