NPIMap

Organization Active NPI

Tender Loving Care Health Care Services of Long Island, LLC

Doing business as Staff Builders Services

  • Home Health Agency
  • Medford, NY
National Provider Identifier
1871628438
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1323L002 Issued in NY
Legal business name
TENDER LOVING CARE HEALTH CARE SERVICES OF LONG ISLAND, LLC
Doing business as
Staff Builders Services
Practice address
1721 A North Ocean Ave
Medford, NY 11763
Phone
(631) 447-2020
NPI assigned
Feb 23, 2007
Organization subpart
Yes
Parent organization
TLC HEALTH CARE SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Authorized official

Name
Willard T Derr
Title
Cfo
Phone
(516) 358-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1323L002 NY Primary

Addresses

Primary practice location

1721 A North Ocean Ave
Medford, NY 11763

Mailing address

1983 Marcus Ave
Suite 200
New Hyde Park, NY 11042-1016
Phone (516) 358-1000

Other identifiers 2

IdentifierTypeStateIssuer
2658217MedicaidNY
2640095MedicaidNY

Other names 1

  • Staff Builders Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Staff Builders Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1871628438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1983 MARCUS AVE",
            "address_2": "SUITE 200",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421016",
            "telephone_number": "516-358-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 A NORTH OCEAN AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "11763",
            "telephone_number": "631-447-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENDER LOVING CARE HEALTH CARE SERVICES OF LONG ISLAND, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TLC HEALTH CARE SERVICES, INC.",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "DERR",
        "authorized_official_first_name": "WILLARD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "516-358-1000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "1323L002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2658217",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2640095",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Staff Builders Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.