Provider Demographics
NPI:1154963742
Name:TENDER CARE SERVICES
Entity type:Organization
Organization Name:TENDER CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:OMOAHOLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:607-592-1611
Mailing Address - Street 1:1212 COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-1443
Mailing Address - Country:US
Mailing Address - Phone:607-592-1611
Mailing Address - Fax:
Practice Address - Street 1:301 GIBSON DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5400
Practice Address - Country:US
Practice Address - Phone:607-592-1611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No174200000XOther Service ProvidersMeals
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care