Provider Demographics
NPI:1912230905
Name:TLB RESIDENTIAL TREATMENT SERVICES, INC.
Entity Type:Organization
Organization Name:TLB RESIDENTIAL TREATMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:FRANCENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUMPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-559-3836
Mailing Address - Street 1:3404 EASTMONT LN
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-2789
Mailing Address - Country:US
Mailing Address - Phone:770-559-3836
Mailing Address - Fax:
Practice Address - Street 1:1000 EXECUTIVE CT
Practice Address - Street 2:STE C
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3185
Practice Address - Country:US
Practice Address - Phone:678-518-9764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder