Organization
TLC SUPPORTED LIVING SERVICES OF AZ, INC
Active
Organization
TLC SUPPORTED LIVING SERVICES OF AZ, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS J KAPLAN (PRESIDENT & CEO)
(928) 537-9744
Entity
Organization
Contact information
Practice address
2500 E COOLEY ST, SUITE 401, SHOW LOW, AZ 85901-5271
(928) 537-9744
(928) 537-5188
Mailing address
2500 E COOLEY ST, SUITE 401, SHOW LOW, AZ 85901-5271
(928) 537-9744
(928) 537-5188
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
DDH1680
AZ
Other
Enumeration date
08/14/2007
Last updated
08/14/2007
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