Provider Demographics
NPI:1053623140
Name:TENDER LOVING CARE HOMES, INC.
Entity type:Organization
Organization Name:TENDER LOVING CARE HOMES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-676-1657
Mailing Address - Street 1:1854 HENDERSONVILLE RD
Mailing Address - Street 2:UNIT 114
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2494
Mailing Address - Country:US
Mailing Address - Phone:828-651-0333
Mailing Address - Fax:
Practice Address - Street 1:2 WALDEN RIDGE DRIVE
Practice Address - Street 2:SUITE #30
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3306
Practice Address - Country:US
Practice Address - Phone:828-676-1657
Practice Address - Fax:828-651-9083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-06
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-011-274251S00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418503Medicaid
NC8303121Medicaid