Provider Demographics
NPI:1447006077
Name:MOBLEY TENDER CARE
Entity type:Organization
Organization Name:MOBLEY TENDER CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SADIQA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-635-3695
Mailing Address - Street 1:29 BANK SPRING CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5117
Mailing Address - Country:US
Mailing Address - Phone:443-635-3695
Mailing Address - Fax:
Practice Address - Street 1:29 BANK SPRING CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5117
Practice Address - Country:US
Practice Address - Phone:443-635-3695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEAKA WAX BAR LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health