TLC Supportive Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

TLC SUPPORTIVE SERVICES LLC

Practice address

1425 Carlin St Apt 6
Reno, NV 89503-4212

Phone

(775) 219-0524

NPI assigned

Dec 22, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Justin T Emerson

Title

Managing Member

Phone

(775) 219-0524

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1513900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513900800000",
    "number": "1972019131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 CARLIN ST APT 6",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034212",
            "telephone_number": "775-219-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 CARLIN ST APT 6",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034212",
            "telephone_number": "775-219-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC SUPPORTIVE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-22",
        "last_updated": "2017-12-22",
        "status": "A",
        "authorized_official_last_name": "EMERSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "775-219-0524",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811376890",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2017; 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.