Provider Demographics
NPI:1881249902
Name:A TENDER HAND ASSISTED LIVING HOME, LLC, DBA
Entity type:Organization
Organization Name:A TENDER HAND ASSISTED LIVING HOME, LLC, DBA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LATANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:MAED LISAC
Authorized Official - Phone:602-488-0135
Mailing Address - Street 1:6216 S 36TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-4904
Mailing Address - Country:US
Mailing Address - Phone:602-488-0135
Mailing Address - Fax:
Practice Address - Street 1:6216 S 36TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-4904
Practice Address - Country:US
Practice Address - Phone:602-488-0135
Practice Address - Fax:602-314-6073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances