Healthcare Provider Details

I. General information

NPI: 1629932314
Provider Name (Legal Business Name): TLC PRIVATE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 BLUE CUT RD
NEWARK NY
14513-1615
US

IV. Provider business mailing address

713 BLUE CUT RD
NEWARK NY
14513-1615
US

V. Phone/Fax

Practice location:
  • Phone: 585-210-3551
  • Fax:
Mailing address:
  • Phone: 585-210-3551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. VERONICA MARY HAUSFELD
Title or Position: OWNER
Credential: LPN
Phone: 585-210-3551