Provider Demographics
NPI:1689136194
Name:TLC PROFESSIONAL HOME CARE SERVICES INC
Entity Type:Organization
Organization Name:TLC PROFESSIONAL HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERCIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:MSN,RN
Authorized Official - Phone:407-924-3979
Mailing Address - Street 1:687 S BLUFORD AVE
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-2752
Mailing Address - Country:US
Mailing Address - Phone:407-924-3979
Mailing Address - Fax:407-876-4426
Practice Address - Street 1:687 S BLUFORD AVE
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-2752
Practice Address - Country:US
Practice Address - Phone:407-924-3979
Practice Address - Fax:407-876-4426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care