Provider Demographics
NPI:1306307194
Name:TLEC CORP
Entity type:Organization
Organization Name:TLEC CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-553-3333
Mailing Address - Street 1:40200 GRAND RIVER AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2163
Mailing Address - Country:US
Mailing Address - Phone:248-553-3333
Mailing Address - Fax:248-553-3377
Practice Address - Street 1:40200 GRAND RIVER AVE STE 300
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2163
Practice Address - Country:US
Practice Address - Phone:248-553-3333
Practice Address - Fax:248-553-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based