Provider Demographics
NPI:1700638210
Name:TLC GROUP ASSOCIATES
Entity type:Organization
Organization Name:TLC GROUP ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:980-214-4967
Mailing Address - Street 1:2843 DONEGAL DR
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-6454
Mailing Address - Country:US
Mailing Address - Phone:980-214-4967
Mailing Address - Fax:
Practice Address - Street 1:2843 DONEGAL DR
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-6454
Practice Address - Country:US
Practice Address - Phone:980-214-4967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health