Provider Demographics
NPI:1427420850
Name:TLC ESATES, LLC
Entity type:Organization
Organization Name:TLC ESATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSINA
Authorized Official - Middle Name:AMOR
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-468-7556
Mailing Address - Street 1:PO BOX 872
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-0872
Mailing Address - Country:US
Mailing Address - Phone:256-468-7556
Mailing Address - Fax:
Practice Address - Street 1:104 CASTLE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8674
Practice Address - Country:US
Practice Address - Phone:256-468-7556
Practice Address - Fax:256-325-0733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-25
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health