Organization
TENDER HEART ADULT DAY HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NELLY SUPAPO LIZASO MBA (ADMINISTRATOR)
(760) 244-8776
Entity
Organization
Contact information
Practice address
9499 I AVE, HESPERIA, CA 92345-6282
(760) 244-8776
(760) 244-9456
Mailing address
9499 I AVE, HESPERIA, CA 92345-6282
(760) 244-8776
(760) 244-9456
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ADU70199F
ADULT DAY HEALTH CARE
CA
Enumeration date
11/24/2006
Last updated
08/22/2020
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