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Organization
TENDERCARE MICHIGAN INC.
Active
Organization
TENDERCARE MICHIGAN INC.
Active
Other names
Tendercare Portage
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA JO THIEL (DIRECTOR OF COMPLIANCE)
(414) 908-8119
Entity
Organization
Contact information
Practice address
7855 CURRIER DR, PORTAGE, MI 49002-4314
(269) 323-7748
(269) 323-1908
Mailing address
111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
(414) 908-8119
(414) 908-8481
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
394180
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
602617304
—
MI
Enumeration date
06/17/2006
Last updated
02/19/2014
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