Provider Demographics
NPI:1861491417
Name:TENDER CARE HOME HEALTH
Entity Type:Organization
Organization Name:TENDER CARE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAY
Authorized Official - Middle Name:LAY
Authorized Official - Last Name:MAK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:626-943-8988
Mailing Address - Street 1:317 W LAS TUNAS DR
Mailing Address - Street 2:208
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1250
Mailing Address - Country:US
Mailing Address - Phone:626-943-8988
Mailing Address - Fax:626-943-8999
Practice Address - Street 1:317 W LAS TUNAS DR
Practice Address - Street 2:208
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1250
Practice Address - Country:US
Practice Address - Phone:626-943-8988
Practice Address - Fax:626-943-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-16
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA980000954251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA57603FMedicaid
557603Medicare Oscar/Certification