Provider Demographics
NPI:1700191996
Name:TENDER CARE HOME FOR ADUTS
Entity Type:Organization
Organization Name:TENDER CARE HOME FOR ADUTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-800-9948
Mailing Address - Street 1:3600 CHAMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-3118
Mailing Address - Country:US
Mailing Address - Phone:817-800-9948
Mailing Address - Fax:817-557-5434
Practice Address - Street 1:3600 CHAMBERLAND DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-3118
Practice Address - Country:US
Practice Address - Phone:817-800-9948
Practice Address - Fax:817-557-5434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114288310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility