Healthcare Provider Details

I. General information

NPI: 1053855916
Provider Name (Legal Business Name): TLC SOULUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2016
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2691 SYLVAN SHORES DR
WATERFORD MI
48328-3936
US

IV. Provider business mailing address

2691 SYLVAN SHORES DR
WATERFORD MI
48328-3936
US

V. Phone/Fax

Practice location:
  • Phone: 248-842-0068
  • Fax:
Mailing address:
  • Phone: 248-842-0068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number6801088993
License Number StateMI

VIII. Authorized Official

Name: NANCY MAE NICHOLSON
Title or Position: LMSW
Credential: LMSW
Phone: 248-842-0068