Healthcare Provider Details

I. General information

NPI: 1689175010
Provider Name (Legal Business Name): TLC COMPANIONS OF TRINITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 02/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 CYPRESS BROOK DR
TRINITY FL
34655-4417
US

IV. Provider business mailing address

1805 CYPRESS BROOK DR
TRINITY FL
34655-4417
US

V. Phone/Fax

Practice location:
  • Phone: 727-312-4429
  • Fax: 727-312-3745
Mailing address:
  • Phone: 727-312-4429
  • Fax: 727-312-3745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number235048
License Number StateFL

VIII. Authorized Official

Name: MRS. DAWN ROBINSON
Title or Position: OWNER
Credential:
Phone: 727-312-4429