Provider Demographics
NPI:1194123604
Name:TENDER HEARTS
Entity type:Organization
Organization Name:TENDER HEARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-835-8793
Mailing Address - Street 1:419 BRANDL DR NW
Mailing Address - Street 2:
Mailing Address - City:BLACKDUCK
Mailing Address - State:MN
Mailing Address - Zip Code:56630-2182
Mailing Address - Country:US
Mailing Address - Phone:218-835-8793
Mailing Address - Fax:
Practice Address - Street 1:419 BRANDL DR NW
Practice Address - Street 2:
Practice Address - City:BLACKDUCK
Practice Address - State:MN
Practice Address - Zip Code:56630-2182
Practice Address - Country:US
Practice Address - Phone:218-835-8793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1076528-1-AFC253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency