Provider Demographics
NPI:1306287420
Name:TLCS MANAGEMENT, LLC
Entity type:Organization
Organization Name:TLCS MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOURIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-214-0100
Mailing Address - Street 1:5505 BELLS FERRY RD
Mailing Address - Street 2:BLDG 300, SUITE 240
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-7527
Mailing Address - Country:US
Mailing Address - Phone:678-214-0100
Mailing Address - Fax:678-214-0124
Practice Address - Street 1:5505 BELLS FERRY RD
Practice Address - Street 2:BLDG 300, SUITE 240
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-7527
Practice Address - Country:US
Practice Address - Phone:678-214-0100
Practice Address - Fax:678-214-0124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALC2007028196208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty