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General NPI Number Information
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NPI Number | 1255977955
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Entity Type | Organization
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Legal Business Name | TLC HOMECARE INC
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Dates
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Enumeration Date | 11/18/2019
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 3017 DOUGLAS BLVD STE 300
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City | ROSEVILLE
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State | CA
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Zip | 95661-3850
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Country | US
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Telephone | 916-774-7120
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Fax | 916-303-7401
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Provider Business Mailing Address
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Address Line | 3017 DOUGLAS BLVD STE 300
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City | ROSEVILLE
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State | CA
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Zip | 95661-3850
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Country | US
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Telephone | 916-774-7120
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | WILLIAM JOSEPH PENNINGTON
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Credential |
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Telephone | 916-761-7924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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