Provider Demographics
NPI:1619389913
Name:TENDER HEARTS HEALTHCARE
Entity Type:Organization
Organization Name:TENDER HEARTS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-887-8102
Mailing Address - Street 1:2050 BALLENGER AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-6847
Mailing Address - Country:US
Mailing Address - Phone:571-551-6052
Mailing Address - Fax:
Practice Address - Street 1:2050 BALLENGER AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-6847
Practice Address - Country:US
Practice Address - Phone:571-551-6052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO141086251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health