Provider Demographics
NPI:1740752179
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:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABDIAZIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-215-7457
Mailing Address - Street 1:2625 E FRANKLIN AVE STE LL5
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-1195
Mailing Address - Country:US
Mailing Address - Phone:952-215-7456
Mailing Address - Fax:
Practice Address - Street 1:2625 E FRANKLIN AVE STE LL5
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1195
Practice Address - Country:US
Practice Address - Phone:952-215-7456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-25
Last Update Date:2018-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health