Provider Demographics
NPI:1245430875
Name:TLC ENTERPRISE, INC.
Entity Type:Organization
Organization Name:TLC ENTERPRISE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSLYNN
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-579-4632
Mailing Address - Street 1:30141 ANTELOPE RD
Mailing Address - Street 2:STE. D647
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-8066
Mailing Address - Country:US
Mailing Address - Phone:951-579-4632
Mailing Address - Fax:888-377-1590
Practice Address - Street 1:23529 LITTLE CREEK DR
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:CA
Practice Address - Zip Code:92587-7431
Practice Address - Country:US
Practice Address - Phone:951-579-4632
Practice Address - Fax:888-377-1590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-22
Last Update Date:2007-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)