MEDICARE: TLE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1205648169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TLE, LLC

Provider Business Mailing Address
First Line	:	3345 W ARBY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-5272
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4229 BETH AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-2851
Country	:	US
Telephone Number	:	725-204-7025
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	OLIVER NAIDAS
Credential	:
Telephone Number	:	702-281-6677

Provider Enumeration Date	:	01/27/2025
Last Update Date	:	01/30/2025

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Directions to “TLE, LLC ” Practice Location

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