Provider Demographics
NPI:1235673534
Name:TLC HOME CARE AND HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:TLC HOME CARE AND HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROCK
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-249-9772
Mailing Address - Street 1:5671 W MILSPRING CIR
Mailing Address - Street 2:
Mailing Address - City:GODFREY
Mailing Address - State:IL
Mailing Address - Zip Code:62035-2135
Mailing Address - Country:US
Mailing Address - Phone:314-249-9772
Mailing Address - Fax:
Practice Address - Street 1:13 DEVONDALE CT
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-5032
Practice Address - Country:US
Practice Address - Phone:314-249-9772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care