Provider Demographics
NPI:1306287628
Name:A TENDER TOUCH IN HOME SERVICES
Entity type:Organization
Organization Name:A TENDER TOUCH IN HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR/FINANCIAL OFFIC
Authorized Official - Prefix:
Authorized Official - First Name:DIONNESHAE
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:FORLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-524-3958
Mailing Address - Street 1:11636 W FLORISSANT AVE
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-6723
Mailing Address - Country:US
Mailing Address - Phone:314-524-3958
Mailing Address - Fax:
Practice Address - Street 1:2159 NURSERY RD #314
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764
Practice Address - Country:US
Practice Address - Phone:813-419-2543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009550400Medicaid