Provider Demographics
NPI:1639597123
Name:AT HOME TLC, INC.
Entity Type:Organization
Organization Name:AT HOME TLC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BRYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-664-0746
Mailing Address - Street 1:10 HOLDEN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2424
Mailing Address - Country:US
Mailing Address - Phone:413-664-0746
Mailing Address - Fax:413-664-6056
Practice Address - Street 1:10 HOLDEN ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2424
Practice Address - Country:US
Practice Address - Phone:413-664-0746
Practice Address - Fax:413-664-6056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-01
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8191251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health