Provider Demographics
NPI:1770756843
Name:TENDER LOVING CARE STAFFING
Entity type:Organization
Organization Name:TENDER LOVING CARE STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYSE
Authorized Official - Middle Name:
Authorized Official - Last Name:HERIVEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-285-2739
Mailing Address - Street 1:92-29 QUEENS BLVD
Mailing Address - Street 2:SUITE CD 1ST FLOOR
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374
Mailing Address - Country:US
Mailing Address - Phone:718-685-2739
Mailing Address - Fax:718-685-2375
Practice Address - Street 1:92-29 QUEENS BLVD
Practice Address - Street 2:SUITE CD 1ST FLOOR
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-685-2739
Practice Address - Fax:718-685-2375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1275478251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health