Provider Demographics
NPI:1942839246
Name:AMAZING TENDER LOVE HOME CARE AGENCY, LLC
Entity Type:Organization
Organization Name:AMAZING TENDER LOVE HOME CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SSENGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-960-4530
Mailing Address - Street 1:9520 TOPANGA CANYON BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-4049
Mailing Address - Country:US
Mailing Address - Phone:818-428-0884
Mailing Address - Fax:818-626-8199
Practice Address - Street 1:9520 TOPANGA CANYON BLVD STE 204
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-4049
Practice Address - Country:US
Practice Address - Phone:818-428-0884
Practice Address - Fax:818-626-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health