Organization
TLS & ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FREDERICK MARVIN TERRY (CEO)
(601) 942-7689
Entity
Organization
Contact information
Practice address
2135 HENRY HILL DR STE 200, JACKSON, MS 39204-2013
(601) 942-7689
Mailing address
2135 HENRY HILL DR STE 200, JACKSON, MS 39204-2013
(601) 942-7689
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063025062
—
MS
05
—
1073763967
—
MS
Enumeration date
04/20/2021
Last updated
04/20/2021
Update your record
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