Tendercare Michigan Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

394180 Issued in MI

Legal business name

TENDERCARE MICHIGAN INC.

Doing business as

Tendercare Portage

Practice address

7855 Currier Dr
Portage, MI 49002-4314

Phone

(269) 323-7748

Fax

(269) 323-1908

NPI assigned

Jun 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Donna Jo Thiel

Title

Director of Compliance

Phone

(414) 908-8119

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tendercare Portage Doing business as

Tax ID family

Medilodge of Portage2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Portage Opco, LLC

  dba Medilodge of Portage

  • Skilled Nursing Facility
  • Portage, MI
  • NPI 1497152565
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1669417473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W MICHIGAN ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532032903",
            "telephone_number": "414-908-8119",
            "fax_number": "414-908-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 CURRIER DR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490024314",
            "telephone_number": "269-323-7748",
            "fax_number": "269-323-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENDERCARE MICHIGAN INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "THIEL",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "414-908-8119",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "394180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "602617304",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tendercare Portage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Taylor
• Kennedy Taylor
• John E Tecca, PHD
• Teletherapy Group, LLC
• Clare Tell
• Cheryl Tenenbaum
• Travis Nathan Tennant, LLMSW
• Terrill Psychological Services PLLC
• Therapize Counseling & Wellness, LLC
• Therapy App

• Skilled Nursing Facility in Portage, MI
• Providers in Portage, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.