Provider Demographics
NPI:1649722075
Name:TC ENTERPRISES
Entity type:Organization
Organization Name:TC ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PREVO
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:860-518-3494
Mailing Address - Street 1:56 COTTAGE PL
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-2106
Mailing Address - Country:US
Mailing Address - Phone:860-919-1337
Mailing Address - Fax:
Practice Address - Street 1:56 COTTAGE PL
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-2106
Practice Address - Country:US
Practice Address - Phone:860-919-1337
Practice Address - Fax:860-357-5226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHCA0001190253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care