Provider Demographics
NPI:1972637593
Name:TENDER LOVING CARE PROFESSIONAL ADULT SITTING SERVICE, INC
Entity type:Organization
Organization Name:TENDER LOVING CARE PROFESSIONAL ADULT SITTING SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIDGETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-392-2291
Mailing Address - Street 1:6207 GENERAL MEYER AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-2015
Mailing Address - Country:US
Mailing Address - Phone:504-392-2291
Mailing Address - Fax:504-392-2271
Practice Address - Street 1:5163 GENERAL DEGAULLE DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-7262
Practice Address - Country:US
Practice Address - Phone:504-392-2291
Practice Address - Fax:504-392-2271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LASIL 10746251E00000X
LARC 12015251E00000X
LASIL 12584251E00000X
LAPCA 12583251E00000X
LAPCA 10745251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1468282Medicaid
LA1172154Medicaid
LA1196410Medicaid
LA1119288Medicaid
LA1468223Medicaid
LA1119016Medicaid
LA1407275Medicaid
LA1468207Medicaid
LA1461385Medicaid