Provider Demographics
NPI:1982021002
Name:TLC HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:TLC HOME HEALTH CARE, LLC
Other - Org Name:TLC HOME HEALTH CARE, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:BRATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:575-885-9199
Mailing Address - Street 1:R 401 N HAPPY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-5731
Mailing Address - Country:US
Mailing Address - Phone:575-885-9199
Mailing Address - Fax:575-628-0029
Practice Address - Street 1:R 401 N HAPPY VALLEY RD
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5731
Practice Address - Country:US
Practice Address - Phone:575-885-9199
Practice Address - Fax:575-628-0029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-26
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM39521389Medicaid