Provider Demographics
NPI:1053292540
Name:INFINITE TENDER LOVING CARE
Entity type:Organization
Organization Name:INFINITE TENDER LOVING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LA GENA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-787-8642
Mailing Address - Street 1:PO BOX 1713
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33509-1713
Mailing Address - Country:US
Mailing Address - Phone:813-787-8642
Mailing Address - Fax:
Practice Address - Street 1:232 KELSEY COVE DR APT 3210
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-4709
Practice Address - Country:US
Practice Address - Phone:813-787-8642
Practice Address - Fax:813-787-8642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities