Provider Demographics
NPI:1598270472
Name:TLC HOME CARE, INC
Entity Type:Organization
Organization Name:TLC HOME CARE, INC
Other - Org Name:TLC HEALTH CARE SERVICES, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAWNISE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-537-3041
Mailing Address - Street 1:400 EASTERN BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-2043
Mailing Address - Country:US
Mailing Address - Phone:334-676-2852
Mailing Address - Fax:334-676-2851
Practice Address - Street 1:400 EASTERN BLVD STE 204
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-2043
Practice Address - Country:US
Practice Address - Phone:334-676-2852
Practice Address - Fax:334-676-2851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL201712715253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care