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General NPI Number Information
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NPI Number | 1437639051
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Entity Type | Organization
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Legal Business Name | TLC HOME AND RESPITE CARE LLC
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Dates
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Enumeration Date | 08/14/2018
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Last Update Date | 08/14/2018
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Provider Practice Location Address
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Address Line | 16910 GARDENVIEW CIR
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City | DETROIT
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State | MI
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Zip | 48228-4331
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Country | US
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Telephone | 844-586-4673
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Fax |
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Provider Business Mailing Address
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Address Line | 17401 E 10 MILE RD
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City | EASTPOINTE
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State | MI
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Zip | 48021-1256
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Country | US
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Telephone | 844-586-4673
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Fax |
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Authorized Official
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Title or Position | CEO AND PRESIDENT
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Name | LATOSHIA PATMAN
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Credential |
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Telephone | 248-703-1421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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