Provider Demographics
NPI:1407097975
Name:TLC PLUS
Entity Type:Organization
Organization Name:TLC PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:B.
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-598-2938
Mailing Address - Street 1:319 LYNNWAY # 321
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1811
Mailing Address - Country:US
Mailing Address - Phone:781-598-2938
Mailing Address - Fax:
Practice Address - Street 1:319 LYNNWAY # 321
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1811
Practice Address - Country:US
Practice Address - Phone:781-598-2938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care