Provider Demographics
NPI:1659743813
Name:TENDER LOVING ENRICHMENT SERVICES
Entity Type:Organization
Organization Name:TENDER LOVING ENRICHMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-272-4585
Mailing Address - Street 1:17434 NW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOUNTSTOWN
Mailing Address - State:FL
Mailing Address - Zip Code:32424
Mailing Address - Country:US
Mailing Address - Phone:850-272-4585
Mailing Address - Fax:
Practice Address - Street 1:17434 NW 11TH ST
Practice Address - Street 2:
Practice Address - City:BLOUNTSTOWN
Practice Address - State:FL
Practice Address - Zip Code:32424
Practice Address - Country:US
Practice Address - Phone:850-272-4585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility