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General NPI Number Information
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NPI Number | 1760020218
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Entity Type | Organization
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Legal Business Name | TLC ADULT DAY CARE AND RECREATION CENTER INC.
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Dates
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Enumeration Date | 12/16/2019
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 3970 TAMPA RD STE J
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City | OLDSMAR
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State | FL
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Zip | 34677-3201
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Country | US
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Telephone | 813-510-4000
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Fax | 813-200-2012
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Provider Business Mailing Address
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Address Line | 3970 TAMPA RD STE J
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City | OLDSMAR
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State | FL
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Zip | 34677-3201
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Country | US
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Telephone | 813-510-4000
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Fax | 813-200-2012
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Authorized Official
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Title or Position | CEO
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Name | MR. THOMAS WINGO
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Credential |
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Telephone | 813-510-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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