Healthcare Provider Details

I. General information

NPI: 1699165779
Provider Name (Legal Business Name): TLC HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2015
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S HALAGUENO ST STE 4
CARLSBAD NM
88220-5748
US

IV. Provider business mailing address

110 S HALAGUENO ST STE 4
CARLSBAD NM
88220-5748
US

V. Phone/Fax

Practice location:
  • Phone: 575-885-0063
  • Fax: 575-885-0065
Mailing address:
  • Phone: 575-885-0063
  • Fax: 575-885-0065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERRY GAIL BRATCHER
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 575-885-9199