Provider Demographics
NPI:1598170516
Name:TLC HOME HEALTH, INC.
Entity Type:Organization
Organization Name:TLC HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:BLOW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:804-458-1852
Mailing Address - Street 1:317 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-2645
Mailing Address - Country:US
Mailing Address - Phone:804-458-1852
Mailing Address - Fax:804-458-2335
Practice Address - Street 1:317 W BROADWAY
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2645
Practice Address - Country:US
Practice Address - Phone:804-458-1852
Practice Address - Fax:804-458-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001094543251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0103809445Medicaid
VA0103314982Medicaid