Provider Demographics
NPI:1154183283
Name:A LOVING TENDER CARE ASSISTED LIVING, LLC
Entity type:Organization
Organization Name:A LOVING TENDER CARE ASSISTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ZDRENTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-833-4852
Mailing Address - Street 1:5622 W ALAMEDA RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-3611
Mailing Address - Country:US
Mailing Address - Phone:623-433-9310
Mailing Address - Fax:
Practice Address - Street 1:5622 W ALAMEDA RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-3611
Practice Address - Country:US
Practice Address - Phone:623-433-9310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility