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Organization
TEACHING LIVING CONCEPTS INC
Active
Organization
TEACHING LIVING CONCEPTS INC
Active
Other names
TLC on Lombard
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VELVET PEREZ (PRESIDENT CEO)
(707) 571-1858
Entity
Organization
Contact information
Practice address
804 LOMBARD WAY, ROHNERT PARK, CA 94928-4504
(707) 795-1715
(707) 664-1356
Mailing address
840 MARK WEST SPRINGS RD, SANTA ROSA, CA 95404-1140
(707) 571-1858
(707) 571-1858
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55G384
STATE PROVIDER ID
CA
01
—
LTC60976G
MEDI-CAL PROVIDER ID
CA
Enumeration date
02/27/2007
Last updated
08/22/2020
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