Provider Demographics
NPI:1639631203
Name:TLC BY KIMLEY
Entity Type:Organization
Organization Name:TLC BY KIMLEY
Other - Org Name:BOUNTIFUL7BLESSINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMLEY
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOWARD FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-309-6550
Mailing Address - Street 1:2514 PARRISH ST
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-1975
Mailing Address - Country:US
Mailing Address - Phone:804-309-6550
Mailing Address - Fax:
Practice Address - Street 1:2514 PARRISH ST
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-1975
Practice Address - Country:US
Practice Address - Phone:804-309-6550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251J00000XAgenciesNursing Care