Provider Demographics
NPI:1225814098
Name:TLT ENDEAVOR, LLC - EUROPEAN CHRISTIAN HOME V
Entity Type:Organization
Organization Name:TLT ENDEAVOR, LLC - EUROPEAN CHRISTIAN HOME V
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-397-2591
Mailing Address - Street 1:14402 HELWIG AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-5022
Mailing Address - Country:US
Mailing Address - Phone:562-397-2591
Mailing Address - Fax:
Practice Address - Street 1:14402 HELWIG AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-5022
Practice Address - Country:US
Practice Address - Phone:562-397-2591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility