| Center For Tlc | |
|
30330 Hickey Rd Chesterfield MI 48051-3911 | |
| (586) 421-4062 | |
| (586) 421-4072 |
| Full Name | Center For Tlc |
|---|---|
| Speciality | Clinic/Center |
| Location | 30330 Hickey Rd, Chesterfield, Michigan |
| Authorized Official Name and Position | Sarah Landrum (HR GENERALIST) |
| Authorized Official Contact | 5864214062 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Tlc 30330 Hickey Rd Chesterfield MI 48051-3911 Ph: (586) 421-4062 | Center For Tlc 30330 Hickey Rd Chesterfield MI 48051-3911 Ph: (586) 421-4062 |
| NPI Number | 1699966341 |
|---|---|
| Provider Enumeration Date | 08/07/2007 |
| Last Update Date | 01/12/2024 |
| Certification Date | 01/12/2024 |
| Medicare PECOS PAC ID | 4486741709 |
|---|---|
| Medicare Enrollment ID | O20150716002003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699966341 | NPI | - | NPPES |
| Provider Name | Amanda R Mangas |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417148222 PECOS PAC ID: 3577650894 Enrollment ID: I20071102000750 |
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