Provider Demographics
NPI:1922482959
Name:TLC OF SOUTH FL HOME MAKER & COMPANION SERVICES LLC
Entity Type:Organization
Organization Name:TLC OF SOUTH FL HOME MAKER & COMPANION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GJELOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-502-4620
Mailing Address - Street 1:5068 NW 74TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5548
Mailing Address - Country:US
Mailing Address - Phone:786-502-4620
Mailing Address - Fax:786-502-4628
Practice Address - Street 1:5068 NW 74TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-5548
Practice Address - Country:US
Practice Address - Phone:786-502-4620
Practice Address - Fax:786-502-4628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty