Provider Demographics
NPI:1962725952
Name:TENDER LOVING CARE HEALTH CARE SERVICES SOUTHEAST, L.L.C.
Entity type:Organization
Organization Name:TENDER LOVING CARE HEALTH CARE SERVICES SOUTHEAST, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LABORDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:1401 MERCANTILE LN
Practice Address - Street 2:SUITE 351
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4301
Practice Address - Country:US
Practice Address - Phone:301-322-6023
Practice Address - Fax:301-322-6858
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TENDER LOVING CARE HEALTH CARE SERVICES SOUTHEAST, L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-05
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHH7149R251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD404695100Medicaid
MD420716502Medicaid
MD420716502Medicaid