Provider Demographics
NPI:1427934769
Name:TENDER LUVIN CARE III CORP
Entity type:Organization
Organization Name:TENDER LUVIN CARE III CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-506-8734
Mailing Address - Street 1:111 WOODCREST DR APT 625
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-8663
Mailing Address - Country:US
Mailing Address - Phone:904-506-8734
Mailing Address - Fax:
Practice Address - Street 1:111 WOODCREST DR APT 625
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-8663
Practice Address - Country:US
Practice Address - Phone:904-506-8734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services