Provider Demographics
NPI:1821295437
Name:TENDER CARE INC.
Entity Type:Organization
Organization Name:TENDER CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V-P
Authorized Official - Prefix:MR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:LAVERN
Authorized Official - Last Name:BLACKWELL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:816-383-0576
Mailing Address - Street 1:6804 OLLMEDA ST
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64504-2632
Mailing Address - Country:US
Mailing Address - Phone:816-383-0576
Mailing Address - Fax:816-238-2446
Practice Address - Street 1:6804 OLLMEDA ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64504-2632
Practice Address - Country:US
Practice Address - Phone:816-383-0576
Practice Address - Fax:816-238-2446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00585850251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN=========Medicaid