Provider Demographics
NPI:1104142603
Name:TLC HEALTH NETWORK
Entity type:Organization
Organization Name:TLC HEALTH NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCCROSKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-951-7060
Mailing Address - Street 1:12644 SENECA RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:NY
Mailing Address - Zip Code:14081-9714
Mailing Address - Country:US
Mailing Address - Phone:716-951-7060
Mailing Address - Fax:716-951-7168
Practice Address - Street 1:845 ROUTES 5 & 20
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:NY
Practice Address - Zip Code:14081
Practice Address - Country:US
Practice Address - Phone:716-951-7283
Practice Address - Fax:716-951-7046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY33S132Medicare PIN