Provider Demographics
NPI:1265626725
Name:TLC GROUP
Entity type:Organization
Organization Name:TLC GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROCCO
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:GENOVESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-538-7771
Mailing Address - Street 1:12423 62ND ST N
Mailing Address - Street 2:STE 402
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773
Mailing Address - Country:US
Mailing Address - Phone:727-538-7771
Mailing Address - Fax:727-538-4207
Practice Address - Street 1:12423 62ND ST N
Practice Address - Street 2:STE 402
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773
Practice Address - Country:US
Practice Address - Phone:727-538-7771
Practice Address - Fax:727-538-4207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health