Provider Demographics
NPI:1700830858
Name:TENDER LOVING CARE HEALTH CARE SERVICES WESTERN, LLC
Entity Type:Organization
Organization Name:TENDER LOVING CARE HEALTH CARE SERVICES WESTERN, LLC
Other - Org Name:AMEDISYS HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:30 CORPORATE PARK
Practice Address - Street 2:SUITE 301
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-5131
Practice Address - Country:US
Practice Address - Phone:949-707-3000
Practice Address - Fax:949-707-3031
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TLC HEALTH CARE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA080000328251E00000X
CA060000326251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA557216OtherCA BC PRUDENT BUYER
CA557216OtherCALIFORNIA BC CA
CA557216OtherCA BC FED EMPLOYEES PROG
CAHHA57216GMedicaid
CAZZZ65950ZOtherCALIFORNIA BLUE SHEILD
CAZZZ65950ZOtherCALIFORNIA BLUE SHEILD