Provider Demographics
NPI:1851054555
Name:TENSEL LLC-TCM
Entity Type:Organization
Organization Name:TENSEL LLC-TCM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:TENSEL
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:208-241-2349
Mailing Address - Street 1:1077 DOLOSTONE DR
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-5088
Mailing Address - Country:US
Mailing Address - Phone:208-241-2349
Mailing Address - Fax:
Practice Address - Street 1:1077 DOLOSTONE DR
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-5088
Practice Address - Country:US
Practice Address - Phone:208-241-2349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TENSEL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management