Provider Demographics
NPI:1710700026
Name:TLC HOME HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:TLC HOME HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNNETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-347-0596
Mailing Address - Street 1:130 S INDIAN RIVER DR STE 202
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4353
Mailing Address - Country:US
Mailing Address - Phone:954-347-0596
Mailing Address - Fax:
Practice Address - Street 1:130 S INDIAN RIVER DR STE 202
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4353
Practice Address - Country:US
Practice Address - Phone:954-347-0596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty