| Tlc Supported Living Services Of Az, Inc | |
|
2500 E Cooley St Suite 401 Show Low AZ 85901-5271 | |
| (928) 537-9744 | |
| (928) 537-5188 |
| Full Name | Tlc Supported Living Services Of Az, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2500 E Cooley St, Show Low, Arizona |
| Authorized Official Name and Position | Douglas J Kaplan (PRESIDENT & CEO) |
| Authorized Official Contact | 9285379744 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tlc Supported Living Services Of Az, Inc 2500 E Cooley St Suite 401 Show Low AZ 85901-5271 Ph: (928) 537-9744 | Tlc Supported Living Services Of Az, Inc 2500 E Cooley St Suite 401 Show Low AZ 85901-5271 Ph: (928) 537-9744 |
| NPI Number | 1548452584 |
|---|---|
| Provider Enumeration Date | 08/14/2007 |
| Last Update Date | 08/14/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548452584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | DDH1680 (Arizona) | Primary |
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