Provider Demographics
NPI:1760020218
Name:TLC ADULT DAY CARE AND RECREATION CENTER INC.
Entity Type:Organization
Organization Name:TLC ADULT DAY CARE AND RECREATION CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WINGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-510-4000
Mailing Address - Street 1:3970 TAMPA RD STE J
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3201
Mailing Address - Country:US
Mailing Address - Phone:813-510-4000
Mailing Address - Fax:813-200-2012
Practice Address - Street 1:3970 TAMPA RD STE J
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-3201
Practice Address - Country:US
Practice Address - Phone:813-510-4000
Practice Address - Fax:813-200-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care