Provider Demographics
NPI:1205069051
Name:TENDER LOVING CARE HEALTH CARE SERVICES MIDWEST, LLC
Entity type:Organization
Organization Name:TENDER LOVING CARE HEALTH CARE SERVICES MIDWEST, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:441 WOLF LEDGES PKWY STE 102
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44311-1038
Practice Address - Country:US
Practice Address - Phone:330-252-0237
Practice Address - Fax:330-252-0270
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TENDER LOVING CARE HEALTH SERVICES MIDWEST, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-27
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH367173Medicare Oscar/Certification