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General NPI Number Information
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NPI Number | 1245430875
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Entity Type | Organization
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Legal Business Name | TLC ENTERPRISE, INC.
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Dates
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Enumeration Date | 07/22/2007
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Last Update Date | 07/22/2007
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Provider Practice Location Address
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Address Line | 23529 LITTLE CREEK DR
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City | CANYON LAKE
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State | CA
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Zip | 92587-7431
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Country | US
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Telephone | 951-579-4632
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Fax | 888-377-1590
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Provider Business Mailing Address
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Address Line | 30141 ANTELOPE RD STE. D647
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City | MENIFEE
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State | CA
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Zip | 92584-8066
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Country | US
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Telephone | 951-579-4632
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Fax | 888-377-1590
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ROSLYNN GAIL PALMER
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Credential |
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Telephone | 951-579-4632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State | CA
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