Active NPI
Tendercare Select Properties Inc.
- Skilled Nursing Facility
- Gaylord, MI
National Provider Identifier
1053428052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 694020
- Legal business name
- TENDERCARE SELECT PROPERTIES INC.
- Practice address
- 508 Random LN
Rte. 1
Gaylord, MI 49735-9304 - Phone
- (989) 732-3508
- Fax
- (989) 731-5260
- NPI assigned
- Aug 24, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Donna J. Maassen
- Title
- Privacy Officer
- Phone
- (414) 908-8119
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 694020 | MI | Primary |
Addresses
Primary practice location
508 Random LN
Rte. 1
Gaylord, MI 49735-9304
Mailing address
209 E Portage Ave
Sault Sainte Marie, MI 49783-4200
Phone (906) 635-0020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3294217 | Medicaid | MI |
Other names 1
- Tendercare Gaylord
National Provider Directory
National Provider DirectoryLocations
508 Random Ln
#1
Gaylord, MI 49735
Phone (989) 732-3508
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1204675200000",
"number": "1053428052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 E PORTAGE AVE",
"city": "SAULT SAINTE MARIE",
"state": "MI",
"postal_code": "497834200",
"telephone_number": "906-635-0020",
"fax_number": "906-635-0212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 RANDOM LN",
"address_2": "RTE. 1",
"city": "GAYLORD",
"state": "MI",
"postal_code": "497359304",
"telephone_number": "989-732-3508",
"fax_number": "989-731-5260"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TENDERCARE SELECT PROPERTIES INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-24",
"last_updated": "2008-03-05",
"status": "A",
"authorized_official_last_name": "MAASSEN",
"authorized_official_first_name": "DONNA",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "PRIVACY OFFICER",
"authorized_official_telephone_number": "414-908-8119",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MI",
"license": "694020",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3294217",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Tendercare Gaylord",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gaylord, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.