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General NPI Number Information
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NPI Number | 1881823425
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Entity Type | Organization
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Legal Business Name | TLC NURSING AIDE AT HOME, INC.
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Dates
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Enumeration Date | 07/03/2009
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Last Update Date | 07/03/2009
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Provider Practice Location Address
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Address Line | 2745 WOODCROFT RD
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City | COLUMBUS
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State | OH
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Zip | 43204-2262
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Country | US
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Telephone | 614-218-3043
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Fax | 314-667-1756
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Provider Business Mailing Address
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Address Line | 2745 WOODCROFT RD
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City | COLUMBUS
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State | OH
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Zip | 43204-2262
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Country | US
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Telephone | 614-218-3043
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Fax | 314-667-1756
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ANTHEA CANDICE COOPER
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Credential |
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Telephone | 614-218-3043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 50103771105
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 102356
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License Number State | OH
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