Provider Demographics
NPI:1669649372
Name:TLC IN-HOME CARE SERVICES, INC
Entity Type:Organization
Organization Name:TLC IN-HOME CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRATIANNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-242-2977
Mailing Address - Street 1:1042 GALBRAITH DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-3372
Mailing Address - Country:US
Mailing Address - Phone:563-242-2977
Mailing Address - Fax:563-242-4188
Practice Address - Street 1:1042 GALBRAITH DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-3372
Practice Address - Country:US
Practice Address - Phone:563-242-2977
Practice Address - Fax:563-242-4188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0240002Medicaid