Provider Demographics
NPI:1467214213
Name:TLC RIDES LLC
Entity Type:Organization
Organization Name:TLC RIDES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:L
Authorized Official - Last Name:THIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-212-1446
Mailing Address - Street 1:115 E FIRST AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911
Mailing Address - Country:US
Mailing Address - Phone:920-212-1446
Mailing Address - Fax:
Practice Address - Street 1:115 E FIRST AVE APT 12
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911
Practice Address - Country:US
Practice Address - Phone:920-212-1446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)