Provider Demographics
NPI:1598998031
Name:TLC BEHAVIORAL SERVICES, LLC
Entity Type:Organization
Organization Name:TLC BEHAVIORAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:770-310-9893
Mailing Address - Street 1:114 KIRTON TURN
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-2422
Mailing Address - Country:US
Mailing Address - Phone:770-310-9893
Mailing Address - Fax:770-487-2470
Practice Address - Street 1:114 KIRTON TURN
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-2422
Practice Address - Country:US
Practice Address - Phone:770-310-9893
Practice Address - Fax:770-487-2470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health