Provider Demographics
NPI:1992454029
Name:TENDER LIVING CARE, LLC
Entity type:Organization
Organization Name:TENDER LIVING CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TANYELLE
Authorized Official - Middle Name:LATOYA
Authorized Official - Last Name:ROLLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-349-6489
Mailing Address - Street 1:3340 ROBINWOOD RD STE 100-412
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-6689
Mailing Address - Country:US
Mailing Address - Phone:980-349-6489
Mailing Address - Fax:
Practice Address - Street 1:2493 GLYNCASTLE WAY
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-7511
Practice Address - Country:US
Practice Address - Phone:980-349-6489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities