Provider Demographics
NPI:1538949417
Name:TLC JOURNEY
Entity type:Organization
Organization Name:TLC JOURNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:CHARRONE
Authorized Official - Last Name:JETER-JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-435-8549
Mailing Address - Street 1:8617 FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234
Mailing Address - Country:US
Mailing Address - Phone:410-435-8549
Mailing Address - Fax:
Practice Address - Street 1:8617 FOWLER AVE
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234
Practice Address - Country:US
Practice Address - Phone:410-435-8549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TLC JOURNEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty