Provider Demographics
NPI:1457042160
Name:OZZIE'S TLC HEALTHCARE AGENCY
Entity Type:Organization
Organization Name:OZZIE'S TLC HEALTHCARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAVITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER/HEALTHCARE ADM
Authorized Official - Phone:901-361-8922
Mailing Address - Street 1:4473 TRACY LYNN DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-3509
Mailing Address - Country:US
Mailing Address - Phone:901-361-8922
Mailing Address - Fax:
Practice Address - Street 1:4473 TRACY LYNN DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-3509
Practice Address - Country:US
Practice Address - Phone:901-361-8922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care