Provider Demographics
NPI:1609354539
Name:TC PERSONAL CARE, LLC
Entity Type:Organization
Organization Name:TC PERSONAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:EDDINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-218-2948
Mailing Address - Street 1:2850 TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-4872
Mailing Address - Country:US
Mailing Address - Phone:231-218-2948
Mailing Address - Fax:231-941-4297
Practice Address - Street 1:461 MUNSON AVE
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-3577
Practice Address - Country:US
Practice Address - Phone:231-947-4626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility