Organization
TLC HEALTHCARE SVS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMY M BRADFORD (DIRECTOR)
(612) 965-6819
Entity
Organization
Contact information
Practice address
3300 COUNTY ROAD 10 # M, SUITE 400I(LETTER I), BROOKLYN CENTER, MN 55429-3072
(612) 965-6819
Mailing address
3300 COUNTY ROAD 10, SUITE 400I(LETTER I), BROOKLYN CENTER, MN 55429-3072
(612) 965-6819
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
350307
MN
251E00000X
Home Health Agency
Primary
350307
MN
251J00000X
Nursing Care Agency
350307
MN
253Z00000X
In Home Supportive Care Agency
350307
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350307
HOMECARE
MN
Enumeration date
01/13/2011
Last updated
01/13/2011
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