Provider Demographics
NPI:1669862793
Name:TLC HOME CARE LLC
Entity Type:Organization
Organization Name:TLC HOME CARE LLC
Other - Org Name:TLC HOME CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAVAEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-602-5811
Mailing Address - Street 1:500 E TUDOR RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-7377
Mailing Address - Country:US
Mailing Address - Phone:907-602-5811
Mailing Address - Fax:
Practice Address - Street 1:500 E TUDOR RD STE 200
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-7377
Practice Address - Country:US
Practice Address - Phone:907-602-5811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
AK1015887251G00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care