Healthcare Provider Details

I. General information

NPI: 1154383412
Provider Name (Legal Business Name): TLC HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 W WARM SPRINGS RD
HENDERSON NV
89014-3586
US

IV. Provider business mailing address

1500 W WARM SPRINGS RD
HENDERSON NV
89014-3586
US

V. Phone/Fax

Practice location:
  • Phone: 702-547-6700
  • Fax: 702-547-0291
Mailing address:
  • Phone: 702-547-6700
  • Fax: 702-547-0291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2391SNF-8
License Number StateNV

VIII. Authorized Official

Name: MRS. ROBBIE D. WILLIAMS
Title or Position: ADMINISTRATOR
Credential: MHA, MBA
Phone: 702-547-6700