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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