Organization
TLC SUPPORTIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN T EMERSON (MANAGING MEMBER)
(775) 219-0524
Entity
Organization
Contact information
Practice address
1425 CARLIN ST APT 6, RENO, NV 89503-4212
(775) 219-0524
Mailing address
1425 CARLIN ST APT 6, RENO, NV 89503-4212
(775) 219-0524
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811376890
—
NV
Enumeration date
12/22/2017
Last updated
12/22/2017
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