Provider Demographics
NPI:1962456038
Name:TENDER LOVING CARE HEALTH CARE SERVICES OF MICHIGAN, LLC
Entity Type:Organization
Organization Name:TENDER LOVING CARE HEALTH CARE SERVICES OF MICHIGAN, LLC
Other - Org Name:TENDER LOVING CARE, AN AMEDISYS COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-298-3548
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:1055 CHARTER DR
Practice Address - Street 2:STE 100
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3589
Practice Address - Country:US
Practice Address - Phone:810-600-6000
Practice Address - Fax:810-600-6006
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TLC HEALTH CARE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-21
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E956OtherMICHIGAN BC BS
MI4746300Medicaid
MI15/4746300Medicaid
MI15/4746392Medicaid
MI4746392Medicaid
MI4746356Medicaid
MI15/4746356Medicaid
MI237294Medicare Oscar/Certification