Healthcare Provider Details

I. General information

NPI: 1558387530
Provider Name (Legal Business Name): TLC ASSISTED LIVING SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 CENTRAL AVE SUITE 334
ASHLAND KY
41101-7767
US

IV. Provider business mailing address

1701 CENTRAL AVE SUITE 334
ASHLAND KY
41101-7767
US

V. Phone/Fax

Practice location:
  • Phone: 606-327-2701
  • Fax: 606-327-5606
Mailing address:
  • Phone: 606-327-2701
  • Fax: 606-327-5606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. REBECCA JANE MANNON
Title or Position: OWNER/ADMINISTRATOR
Credential: RN
Phone: 606-327-2701