Provider Demographics
NPI:1649627084
Name:TENDER HEARTS SENIOR CARE, LLC
Entity type:Organization
Organization Name:TENDER HEARTS SENIOR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:WITTIG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:920-459-0791
Mailing Address - Street 1:2125 S MEMORIAL PL
Mailing Address - Street 2:STE 3
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-3772
Mailing Address - Country:US
Mailing Address - Phone:920-459-0791
Mailing Address - Fax:920-459-0792
Practice Address - Street 1:2125 S MEMORIAL PL
Practice Address - Street 2:STE 3
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-3772
Practice Address - Country:US
Practice Address - Phone:920-459-0791
Practice Address - Fax:920-459-0792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management