Organization
TLC PROFESSIONAL SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI WILSON OWENS RN, BSN (MEMBER)
(434) 799-3500
Entity
Organization
Contact information
Practice address
2321 RIVERSIDE DR, SUITE 35, DANVILLE, VA 24540-4267
(434) 799-3500
(434) 799-3525
Mailing address
2321 RIVERSIDE DR, SUITE 35, DANVILLE, VA 24540-4267
(434) 799-3500
(434) 799-3525
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
S5189933
VA
343900000X
Non-emergency Medical Transport (VAN)
S5189933
VA
Other
Enumeration date
08/16/2014
Last updated
09/30/2014
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