Provider Demographics
NPI:1245270511
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:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LABORDE
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 1:1230 E DIEHL RD
Practice Address - Street 2:SUITE 202
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-9353
Practice Address - Country:US
Practice Address - Phone:630-505-4275
Practice Address - Fax:630-505-7370
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TLC HEALTH CARE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-07
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010376251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL50410OtherBCBS
IL364576454005Medicaid
IL1025622OtherIL UNITED HEALTHCARE CONT
IL5104OtherIL BCBS
IL5114OtherBCBS IL
IL1025620OtherUNITED HEALTHCARE
IL147496OtherIL UNICARE HMO PPO
IL50407OtherIL BCBS CONT HH
IL364576454005Medicaid
IL=========001Medicaid