Provider Demographics
NPI:1831843200
Name:TENDRIL HEALTHCARE SERVICES
Entity type:Organization
Organization Name:TENDRIL HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:OLUWAMODUPE
Authorized Official - Middle Name:
Authorized Official - Last Name:IDOWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-218-2018
Mailing Address - Street 1:569 DR MARTIN LUTHER KING JR BLVD STE B04
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-1247
Mailing Address - Country:US
Mailing Address - Phone:862-218-2018
Mailing Address - Fax:
Practice Address - Street 1:569 DR MARTIN LUTHER KING JR BLVD STE B04
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-1247
Practice Address - Country:US
Practice Address - Phone:862-218-2018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health