Provider Demographics
NPI:1598474298
Name:MAJESTIC TENDER CARE, LLC
Entity Type:Organization
Organization Name:MAJESTIC TENDER CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHAFIQUE
Authorized Official - Middle Name:MUSA
Authorized Official - Last Name:KAKOOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-251-7313
Mailing Address - Street 1:185 E WINDMILL LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1716
Mailing Address - Country:US
Mailing Address - Phone:323-251-7313
Mailing Address - Fax:
Practice Address - Street 1:185 E WINDMILL LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1716
Practice Address - Country:US
Practice Address - Phone:323-251-7313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances