Provider Demographics
NPI:1790278455
Name:TENDERCARE SUPPORT LLC
Entity Type:Organization
Organization Name:TENDERCARE SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:E
Authorized Official - Last Name:ESPICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-277-3793
Mailing Address - Street 1:403 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-3138
Mailing Address - Country:US
Mailing Address - Phone:989-277-3793
Mailing Address - Fax:
Practice Address - Street 1:403 E MAIN ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-3138
Practice Address - Country:US
Practice Address - Phone:989-277-3793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
NA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health