Healthcare Provider Details

I. General information

NPI: 1174481410
Provider Name (Legal Business Name): TLC HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MAIN ST
BOURNE MA
02532-3106
US

IV. Provider business mailing address

25 MAIN ST
BOURNE MA
02532-3106
US

V. Phone/Fax

Practice location:
  • Phone: 774-310-3876
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW JOHN BOTICA JR.
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 847-770-2983