Provider Demographics
NPI:1023281698
Name:TENDER CARE HUMAN SERVICES, INC
Entity type:Organization
Organization Name:TENDER CARE HUMAN SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VITULLI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-526-6125
Mailing Address - Street 1:9221 165TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-1103
Mailing Address - Country:US
Mailing Address - Phone:718-526-6125
Mailing Address - Fax:718-526-9629
Practice Address - Street 1:9221 165TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11433-1103
Practice Address - Country:US
Practice Address - Phone:718-526-6125
Practice Address - Fax:718-526-9629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251B00000X251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02209676Medicaid
NY02245430Medicaid
NY02351875Medicaid