Provider Demographics
NPI:1386998631
Name:TLC ADULT CARE LLC
Entity type:Organization
Organization Name:TLC ADULT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-350-3142
Mailing Address - Street 1:16801 E GEORGE FRANKLIN DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-3820
Mailing Address - Country:US
Mailing Address - Phone:816-350-3142
Mailing Address - Fax:816-886-2436
Practice Address - Street 1:16801 E GEORGE FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-3820
Practice Address - Country:US
Practice Address - Phone:816-350-3142
Practice Address - Fax:816-886-2436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOWC1-0410-0212320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities