Provider Demographics
NPI:1730134529
Name:TENDER LOVING CARE HEALTH CARE SERVICES OF ERIE NIAGARA, LLC
Entity Type:Organization
Organization Name:TENDER LOVING CARE HEALTH CARE SERVICES OF ERIE NIAGARA, LLC
Other - Org Name:AMEDISYS HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUSSEROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:3854 AMERICAN WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4013
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:1127 WEHRLE DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14221-7700
Practice Address - Country:US
Practice Address - Phone:716-632-6420
Practice Address - Fax:716-626-7617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1401614251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY553002OtherHEALTHNOW
NY551916011OtherHEALTHNOW INFUSION
NY02640086Medicaid
NY8390061OtherINDEPENDENT HEALTH
NY201031840023OtherTRICARE
NY11189203OtherNY UNIVERSAL
NY553002OtherHEALTHNOW