Organization Name: | TLC ADULT CARE LLC |
NPI Number: | 1386998631 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD L SAXTON (MEMBER) |
Mailing Address: | 16801 E George Franklin Dr Independence |
State: | MO US |
Postal Code: | 640553820 |
Phone Number: | 8163503142 |
Fax Number: | 8168862436 |
NPI Enumeration Date: | 11/07/2012 |
NPI Last Update Date: | 11/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | WC1-0410-0212 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |