Healthcare Provider Details

I. General information

NPI: 1952016552
Provider Name (Legal Business Name): TLC COMFORT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 LAKEVIEW BLVD
WINTER HAVEN FL
33880-1124
US

IV. Provider business mailing address

304 LAKEVIEW BLVD
WINTER HAVEN FL
33880-1124
US

V. Phone/Fax

Practice location:
  • Phone: 863-280-4230
  • Fax:
Mailing address:
  • Phone: 863-280-4230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. CANDACE RAJONDA DUCKING
Title or Position: OWNER
Credential:
Phone: 863-280-4230