Provider Demographics
NPI:1700040359
Name:TLC HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:TLC HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:BRATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:575-885-9199
Mailing Address - Street 1:1022 S BISHOP
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-5337
Mailing Address - Country:US
Mailing Address - Phone:575-706-7241
Mailing Address - Fax:573-341-5557
Practice Address - Street 1:R 401 N HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-8822
Practice Address - Country:US
Practice Address - Phone:575-885-9199
Practice Address - Fax:575-628-0029
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TLC HOME HEALTH CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-14
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006023875163WH0200X
NM3310251E00000X
253Z00000X, 385HR2060X, 385HR2065X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0009814Medicaid
NM39521389Medicaid
NM327209Medicare UPIN
MO0009814Medicaid