Provider Demographics
NPI:1740714013
Name:TENDERIDE LLC
Entity type:Organization
Organization Name:TENDERIDE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRS
Authorized Official - Middle Name:O
Authorized Official - Last Name:OBASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-495-3843
Mailing Address - Street 1:1092 S JASPER ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-3013
Mailing Address - Country:US
Mailing Address - Phone:303-719-9303
Mailing Address - Fax:
Practice Address - Street 1:1092 S JASPER ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80017-3013
Practice Address - Country:US
Practice Address - Phone:303-719-9303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251C00000X
COMCT-0031343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000143173Medicaid