Provider Demographics
NPI:1891149928
Name:TCG HOLDINGS 14, LLC
Entity Type:Organization
Organization Name:TCG HOLDINGS 14, LLC
Other - Org Name:TOTAL CARE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:PFRANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-689-2523
Mailing Address - Street 1:127 N FRANKLIN ST STE 206
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53074-1948
Mailing Address - Country:US
Mailing Address - Phone:262-290-4272
Mailing Address - Fax:262-268-0775
Practice Address - Street 1:127 N FRANKLIN ST STE 206
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:WI
Practice Address - Zip Code:53074-1948
Practice Address - Country:US
Practice Address - Phone:262-290-4272
Practice Address - Fax:262-268-0775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health