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General NPI Number Information
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NPI Number | 1811432339
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Entity Type | Organization
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Legal Business Name | TLC PROFESSIONAL CARE LLC
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Dates
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Enumeration Date | 12/20/2016
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 2300 W MORTON ST STE 123
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City | DENISON
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State | TX
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Zip | 75020-1600
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Country | US
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Telephone | 903-465-7730
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Fax | 903-465-7730
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Provider Business Mailing Address
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Address Line | 2300 W MORTON ST STE 123
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City | DENISON
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State | TX
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Zip | 75020-1600
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Country | US
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Telephone | 903-465-7730
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Fax | 903-465-7730
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | MISTY FULLER
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Credential |
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Telephone | 903-465-7730
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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 | TX
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