Provider Demographics
NPI:1407800584
Name:TENDER LOVING CARE HEALTH CARE SERVICES OF NEW ENGLAND, LLC
Entity type:Organization
Organization Name:TENDER LOVING CARE HEALTH CARE SERVICES OF NEW ENGLAND, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGLICCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-299-3803
Mailing Address - Street 1:3854 AMERICAN WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4013
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:50T AUDUBON RD
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1203
Practice Address - Country:US
Practice Address - Phone:978-685-2818
Practice Address - Fax:978-738-5071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-21
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110080794BMedicaid
MA0608416OtherMA MCD INTERMITTENT
MA120211OtherMASSACUUSETTS BC BS OF MA
MA60 00332OtherEVERCARE
MA201031840015OtherTRICARE HEALTH NET
MA0608416Medicaid
MA201031840015OtherTRICARE HEALTH NET