Provider Demographics
NPI:1609659861
Name:WITH TENDER CARE WTC LLC
Entity Type:Organization
Organization Name:WITH TENDER CARE WTC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEAULO
Authorized Official - Middle Name:S
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LNHA
Authorized Official - Phone:513-504-0495
Mailing Address - Street 1:11366 KING GEORGE DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4400
Mailing Address - Country:US
Mailing Address - Phone:513-504-0495
Mailing Address - Fax:
Practice Address - Street 1:11366 KING GEORGE DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4400
Practice Address - Country:US
Practice Address - Phone:513-504-0495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care