Provider Demographics
NPI:1659248789
Name:TLS THERAPY LLC
Entity type:Organization
Organization Name:TLS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTRL
Authorized Official - Prefix:
Authorized Official - First Name:SUSSY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAUBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-587-5885
Mailing Address - Street 1:11 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-2532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 BROADWAY
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-2532
Practice Address - Country:US
Practice Address - Phone:845-587-5885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-22
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center