Provider Demographics
NPI:1063156883
Name:TENDER HOMECARE
Entity type:Organization
Organization Name:TENDER HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NOOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDIRAZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-838-0783
Mailing Address - Street 1:4409 W GARY WAY
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-4541
Mailing Address - Country:US
Mailing Address - Phone:602-706-2768
Mailing Address - Fax:
Practice Address - Street 1:3330 E VAN BUREN ST APT 133
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6856
Practice Address - Country:US
Practice Address - Phone:602-838-0783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty