MEDICARE: LIAISON TCS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	261QM2800X	Methadone Clinic
3	305S00000X	Point of Service
4	332B00000X	Durable Medical Equipment & Medical Supplies
5	343800000X	Secured Medical Transport (VAN)
6	343900000X	Non-emergency Medical Transport (VAN)
7	347B00000X	Bus
8	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1639942600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIAISON TCS INC.

Provider Business Mailing Address
First Line	:	2238 MICHIGAN AVE STE E
Second Line	:
City	:	DALWORTHINGTON GARDENS
State	:	TX
Zip	:	76013-5931
Country	:	US
Telephone Number	:	323-283-1040
Fax Number	:

Provider Business Practice Location Address
First Line	:	2238 MICHIGAN AVE STE E
Second Line	:
City	:	DALWORTHINGTON GARDENS
State	:	TX
Zip	:	76013-5931
Country	:	US
Telephone Number	:	323-283-1040
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CAROLYN RONIECE LEVIAS
Credential	:
Telephone Number	:	323-283-1040

Provider Enumeration Date	:	11/01/2023
Last Update Date	:	11/10/2023

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Directions to “LIAISON TCS INC. ” Practice Location

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