Temporary Living Center

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

License

1010423 Issued in MN

Legal business name

TEMPORARY LIVING CENTER

Doing business as

TLC

Practice address

7170 Bryant Lake Dr
Eden Prairie, MN 55344-3502

Phone

(952) 942-6400

NPI assigned

May 15, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Jacque Lee Robinson-Richard

Title

Executive Director

Phone

(337) 303-3536

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• TLC Doing business as

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1922275148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7170 BRYANT LAKE DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443502",
            "telephone_number": "952-942-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7170 BRYANT LAKE DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443502",
            "telephone_number": "952-942-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEMPORARY LIVING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "ROBINSON-RICHARD",
        "authorized_official_first_name": "JACQUE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "337-303-3536",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "MN",
            "license": "1010423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN ITS",
            "identifier": "2719550000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nelya S Taylor, RN
• Sandra Hammond Taylor, MA LP
• Naomi Sarah Teetzel, MAOT
• Joshua Patrick Teich, MD
• Anna Martha Teien
• Daniel Romero Teske, LPCC
• Paul Huyphuoc Thai, DDS
• CJ Chuci Thao, PA-C
• The Colony at Eden Prairie
• The Cornerstone MN LLC

• Children's Substance Abuse Rehabilitation Facility in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Children's Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.