Provider Demographics
NPI:1528748472
Name:THE TLC HOUSE AND RESIDENTIAL SERVICES LLC
Entity type:Organization
Organization Name:THE TLC HOUSE AND RESIDENTIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-428-9992
Mailing Address - Street 1:6801 LAKE PLAZA DR STE B213
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4068
Mailing Address - Country:US
Mailing Address - Phone:317-428-9992
Mailing Address - Fax:
Practice Address - Street 1:6801 LAKE PLAZA DR STE B213
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4068
Practice Address - Country:US
Practice Address - Phone:317-428-9992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty