Provider Demographics
NPI:1073857546
Name:TLJ ENTERPRISES
Entity Type:Organization
Organization Name:TLJ ENTERPRISES
Other - Org Name:HOME HELPERS OF NORTHEASTERN IL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ONWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-685-0593
Mailing Address - Street 1:900 DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-4649
Mailing Address - Country:US
Mailing Address - Phone:847-685-0593
Mailing Address - Fax:847-685-0671
Practice Address - Street 1:900 DEVON AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4649
Practice Address - Country:US
Practice Address - Phone:847-685-0593
Practice Address - Fax:847-685-0671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILHF100031253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care