Provider Demographics
NPI:1942668611
Name:TLC YOUR WAY HOME CARE SERVICES, INC.
Entity Type:Organization
Organization Name:TLC YOUR WAY HOME CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:KAWANNA
Authorized Official - Last Name:FEELY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:803-810-2060
Mailing Address - Street 1:6013 SHAMROCK GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CLOVER
Mailing Address - State:SC
Mailing Address - Zip Code:29710-6921
Mailing Address - Country:US
Mailing Address - Phone:803-810-2060
Mailing Address - Fax:
Practice Address - Street 1:4381 CHARLOTTE HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:LAKE WYLIE
Practice Address - State:SC
Practice Address - Zip Code:29710-6535
Practice Address - Country:US
Practice Address - Phone:803-810-2060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCIHCP-0023253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCEX0943Medicaid