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General NPI Number Information
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NPI Number | 1356966063
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Entity Type | Organization
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Legal Business Name | TLC ANGELS, INC
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 1717 CONGRESS ST STE 3
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City | PORTLAND
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State | ME
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Zip | 04102-1983
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Country | US
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Telephone | 207-835-6025
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Fax |
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Provider Business Mailing Address
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Address Line | 461 CAPISIC ST
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City | PORTLAND
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State | ME
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Zip | 04102-1739
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | HR/CASE MGMT.
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Name | BRYN CARLSON
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Credential |
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Telephone | 207-835-6025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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