Healthcare Provider Details

I. General information

NPI: 1073427670
Provider Name (Legal Business Name): TCAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 OLD CUBA RD
EUBANK KY
42567-8793
US

IV. Provider business mailing address

2110 OLD CUBA RD
EUBANK KY
42567-8793
US

V. Phone/Fax

Practice location:
  • Phone: 502-699-4634
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: TINTISHA CLANTON
Title or Position: OWNER
Credential:
Phone: 502-699-4634