Provider Demographics
NPI:1881823425
Name:TLC NURSING AIDE AT HOME, INC.
Entity Type:Organization
Organization Name:TLC NURSING AIDE AT HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANTHEA
Authorized Official - Middle Name:CANDICE
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-218-3043
Mailing Address - Street 1:2745 WOODCROFT RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-2262
Mailing Address - Country:US
Mailing Address - Phone:614-218-3043
Mailing Address - Fax:314-667-1756
Practice Address - Street 1:2745 WOODCROFT RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-2262
Practice Address - Country:US
Practice Address - Phone:614-218-3043
Practice Address - Fax:314-667-1756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-03
Last Update Date:2009-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH102356164W00000X
OH50103771105374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty