Provider Demographics
NPI:1356966063
Name:TLC ANGELS, INC
Entity type:Organization
Organization Name:TLC ANGELS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR/CASE MGMT.
Authorized Official - Prefix:
Authorized Official - First Name:BRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-835-6025
Mailing Address - Street 1:461 CAPISIC ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-1739
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1717 CONGRESS ST STE 3
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-1983
Practice Address - Country:US
Practice Address - Phone:207-835-6025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care