Basic Information
Provider Information
NPI: 1851623946
EntityType: 2
ReplacementNPI:  
OrganizationName: TENDER LOVING CARE HEALTH CARE SERVICES OF NEW ENGLAND, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: AMEDISYS HOME HEALTH CARE
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3854 AMERICAN WAY
Address2: SUITE A
City: BATON ROUGE
State: LA
PostalCode: 708164013
CountryCode: US
TelephoneNumber: 2252922031
FaxNumber: 2252959678
Practice Location
Address1: 290 MERRIMACK ST STE 241
Address2:  
City: LAWRENCE
State: MA
PostalCode: 018431782
CountryCode: US
TelephoneNumber: 9786852818
FaxNumber: 9787385071
Other Information
ProviderEnumerationDate: 02/01/2010
LastUpdateDate: 10/31/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: KUSSEROW
AuthorizedOfficialFirstName: PAUL
AuthorizedOfficialMiddleName: B
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 2252922031
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: TENDER LOVING CARE HEALTH CARE SERVICES OF NEW ENGLAND, LLC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X MAY AgenciesHome Health 

No ID Information.


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