Provider Demographics
NPI:1427188457
Name:TLC HEALTH NETWORK
Entity Type:Organization
Organization Name:TLC HEALTH NETWORK
Other - Org Name:TLC HEALTH NETWORK LONG TERM HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-951-7273
Mailing Address - Street 1:12644 SENECA ROAD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:NY
Mailing Address - Zip Code:14081
Mailing Address - Country:US
Mailing Address - Phone:716-375-6490
Mailing Address - Fax:716-375-7479
Practice Address - Street 1:12644 SENECA ROAD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:NY
Practice Address - Zip Code:14081
Practice Address - Country:US
Practice Address - Phone:716-375-6490
Practice Address - Fax:716-951-7168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00347544Medicaid
NY00347544Medicaid