Provider Demographics
NPI:1619627908
Name:TENDER LIFTED HOPE LLC
Entity Type:Organization
Organization Name:TENDER LIFTED HOPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMSW
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HELMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-258-5966
Mailing Address - Street 1:PO BOX 32214
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48232-0214
Mailing Address - Country:US
Mailing Address - Phone:313-258-5966
Mailing Address - Fax:
Practice Address - Street 1:9623 HEMINGWAY
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48239-2292
Practice Address - Country:US
Practice Address - Phone:313-258-5966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty