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NPI Code Detail

MEDICARE: TLC SKILLED HEALTH CARE PROVIDERS, INC.

MEDICARE: TLC SKILLED HEALTH CARE PROVIDERS, INC.
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
1251E00000XHome Health Agency980000768CA

General Provider Information

NPI Number : 1962409813
Entity Type Code : Organization
Provider Name (Legal Business Name) : TLC SKILLED HEALTH CARE PROVIDERS, INC.
Provider Business Mailing Address
First Line : 3250 WILSHIRE BLVD
Second Line : SUITE # 1008
City : LOS ANGELES
State : CA
Zip : 90010-1577
Country : US
Telephone Number : 213-380-9991
Fax Number : 213-387-2894
Provider Business Practice Location Address
First Line : 3250 WILSHIRE BLVD
Second Line : SUITE # 1008
City : LOS ANGELES
State : CA
Zip : 90010-1577
Country : US
Telephone Number : 213-380-9991
Fax Number : 213-387-2894
Authorized Official
Title or Position : CEO/ ADMINISTRATOR
Name : MISS MARIA ASUNCION POLINTAN TATOY
Credential :
Telephone Number : 213-380-9991
Provider Enumeration Date : 07/07/2005
Last Update Date : 09/04/2015

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