Provider Demographics
NPI:1568938447
Name:TRUSTING LOYAL CARING TLC HOMEMAKERS SERVICE
Entity Type:Organization
Organization Name:TRUSTING LOYAL CARING TLC HOMEMAKERS SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLYNN
Authorized Official - Middle Name:NORA
Authorized Official - Last Name:STANDIFER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:662-402-6990
Mailing Address - Street 1:59 NOBLIN RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-9571
Mailing Address - Country:US
Mailing Address - Phone:662-402-6990
Mailing Address - Fax:662-000-0000
Practice Address - Street 1:59 NOBLIN ROAD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-9571
Practice Address - Country:US
Practice Address - Phone:662-402-6990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health