Provider Demographics
NPI:1639942600
Name:LIAISON TCS INC.
Entity type:Organization
Organization Name:LIAISON TCS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:RONIECE
Authorized Official - Last Name:LEVIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-283-1040
Mailing Address - Street 1:2238 MICHIGAN AVE STE E
Mailing Address - Street 2:
Mailing Address - City:DALWORTHINGTON GARDENS
Mailing Address - State:TX
Mailing Address - Zip Code:76013-5931
Mailing Address - Country:US
Mailing Address - Phone:323-283-1040
Mailing Address - Fax:
Practice Address - Street 1:2238 MICHIGAN AVE STE E
Practice Address - Street 2:
Practice Address - City:DALWORTHINGTON GARDENS
Practice Address - State:TX
Practice Address - Zip Code:76013-5931
Practice Address - Country:US
Practice Address - Phone:323-283-1040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-01
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No253Z00000XAgenciesIn Home Supportive Care
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No305S00000XManaged Care OrganizationsPoint of Service
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347B00000XTransportation ServicesBus