Provider Demographics
NPI:1912199738
Name:TENDERCARE HOME SERVICES INC.
Entity Type:Organization
Organization Name:TENDERCARE HOME SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MALOBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-535-5113
Mailing Address - Street 1:4957 BROOKLYN BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-3405
Mailing Address - Country:US
Mailing Address - Phone:763-535-5113
Mailing Address - Fax:763-537-2553
Practice Address - Street 1:9700 45TH AVE N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55442-2664
Practice Address - Country:US
Practice Address - Phone:763-551-7326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2278H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedHome HealthGroup - Single Specialty