1639393770 NPI number — TENDER LOVING CARE PROFESSIONAL ADULT SITTING SERVICE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639393770 NPI number — TENDER LOVING CARE PROFESSIONAL ADULT SITTING SERVICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TENDER LOVING CARE PROFESSIONAL ADULT SITTING SERVICE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639393770
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6207 GENERAL MEYER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70131-2015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-392-2291
Provider Business Mailing Address Fax Number:
504-392-2271

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5163 GENERAL DEGAULLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70131-7262
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-392-2291
Provider Business Practice Location Address Fax Number:
504-392-2271
Provider Enumeration Date:
04/12/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GREEN
Authorized Official First Name:
BRIDGETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF SERVICES
Authorized Official Telephone Number:
504-392-2291

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  SIL 10746 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: PCA 10745 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: RC 12015 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: SIL 12584 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: PCA 12583 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: PCA 17030 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1408174 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".