TLC Adult Group Home

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

MHL#032-441 Issued in NC

Legal business name

TLC ADULT GROUP HOME

Practice address

401 Moline St
Durham, NC 27707-2347

Phone

(919) 937-3437

NPI assigned

Aug 13, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Renee Hazelwood

Title

Administrator

Phone

(919) 937-3437

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1720234495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11998",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277031998",
            "telephone_number": "919-937-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MOLINE ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072347",
            "telephone_number": "919-937-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC ADULT GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "HAZELWOOD",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-937-3437",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NC",
            "license": "MHL#032-441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Jean Tisdal, MSN, A-GNP-C
• Grace Naa Ayorkor Tisdale, MD
• Kathleen Marie Tise, LCSW
• James Franklin Titch, CRNA
• Krystal Strand Titus-Rains, PHARMD
• TNT Transport Services
• Teofilo Tobes Jr., RN
• Dana Jean Tobey, CRNA
• Katie Spencer Tobik, MGCS
• Rachel Sydney Tobin, MD

• Adult Mental Health Clinic/Center in Durham, NC
• Providers in Durham, NC by specialty
• Adult Mental Health Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.