Provider Demographics
NPI:1699018887
Name:TLC HOSPICE, L.L.C.
Entity Type:Organization
Organization Name:TLC HOSPICE, L.L.C.
Other - Org Name:ANVOI NEW MEXICO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-841-2209
Mailing Address - Street 1:1013 N CAUSEWAY BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-4100
Mailing Address - Country:US
Mailing Address - Phone:504-841-2209
Mailing Address - Fax:504-569-5052
Practice Address - Street 1:705 PASEO DEL PUEBLO SUR STE B
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-5015
Practice Address - Country:US
Practice Address - Phone:575-737-0681
Practice Address - Fax:855-275-6479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-05
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM25929712Medicaid