| Tlj, Inc. | |
|
25w Old Westport Rd Dartmouth MA 02747-2513 | |
| (508) 982-4755 | |
| (877) 308-2202 |
| Full Name | Tlj, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 25w Old Westport Rd, Dartmouth, Massachusetts |
| Authorized Official Name and Position | Ilene G Levine (OWNER) |
| Authorized Official Contact | 5089824755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tlj, Inc. 22 Onyx Dr Dartmouth MA 02747-3521 Ph: (508) 982-4755 | Tlj, Inc. 25w Old Westport Rd Dartmouth MA 02747-2513 Ph: (508) 982-4755 |
| NPI Number | 1467911990 |
|---|---|
| Provider Enumeration Date | 03/14/2019 |
| Last Update Date | 03/14/2019 |
| Medicare PECOS PAC ID | 3678917135 |
|---|---|
| Medicare Enrollment ID | O20240223000276 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467911990 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Ilene Gould Levine |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689623480 PECOS PAC ID: 5496199952 Enrollment ID: I20240223000335 |
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