Healthcare Provider Details

I. General information

NPI: 1992476824
Provider Name (Legal Business Name): TLC HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 09/21/2021
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 W MERMOD ST
CARLSBAD NM
88220-5731
US

IV. Provider business mailing address

320 W MERMOD ST
CARLSBAD NM
88220-5731
US

V. Phone/Fax

Practice location:
  • Phone: 575-885-9199
  • Fax: 575-628-0029
Mailing address:
  • Phone: 575-885-9199
  • Fax: 575-628-0029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TERRY GAIL BRATCHER
Title or Position: ADMINISTRATOR/OWNER
Credential: NURSE
Phone: 575-885-9199