Healthcare Provider Details

I. General information

NPI: 1376036038
Provider Name (Legal Business Name): TLK MANAGEMENT CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 06/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4515 S MCCLINTOCK DR
TEMPE AZ
85282-7376
US

IV. Provider business mailing address

4515 S MCCLINTOCK DR
TEMPE AZ
85282-7376
US

V. Phone/Fax

Practice location:
  • Phone: 623-217-6942
  • Fax:
Mailing address:
  • Phone: 623-217-6942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. TODD M MCDONALD
Title or Position: PRESIDENT
Credential: MS
Phone: 623-217-6942