Provider Demographics
NPI:1295980498
Name:TENDER LOVING CARE HEALTH CARE SERVICES SOUTHEAST, L.L.C
Entity type:Organization
Organization Name:TENDER LOVING CARE HEALTH CARE SERVICES SOUTHEAST, L.L.C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
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 1:1540 BREEZEPORT WAY
Practice Address - Street 2:SUITE 600
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3752
Practice Address - Country:US
Practice Address - Phone:757-483-8914
Practice Address - Fax:757-484-3723
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TENDER LOVING CARE HEALTH CARE SERVICES SOUTHEAST, L.L.C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-02
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1295980498Medicaid
VA1295980498Medicaid