Provider Demographics
NPI:1396986675
Name:TENDER LOVING MERCY
Entity type:Organization
Organization Name:TENDER LOVING MERCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:NUGENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-726-7833
Mailing Address - Street 1:909 W VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6278
Mailing Address - Country:US
Mailing Address - Phone:760-726-7833
Mailing Address - Fax:760-726-7814
Practice Address - Street 1:909 W VISTA WAY
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6278
Practice Address - Country:US
Practice Address - Phone:760-726-7833
Practice Address - Fax:760-726-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility