| Entity Name: | TLC COMFORT CARE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 23 Oct 2024 (4 months ago) |
| Document Number: | L24000451370 |
| Address: | 302 LAKEVIEW BLVD, WINTER HAVEN, FL 33880 FL |
| Mail Address: | 302 LAKEVIEW BLVD, WINTER HAVEN, FL 33880 FL |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902512825 | 2023-01-24 | 2023-01-24 | 302 LAKEVIEW BLVD, WINTER HAVEN, FL, 338801124, US | 302 LAKEVIEW BLVD, WINTER HAVEN, FL, 338801124, US | |||||||||||||||||||
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| Phone | +1 863-280-4230 |
Authorized person
| Name | CANDACE R DUCKING |
| Role | OWNER |
| Phone | 8632804230 |
Taxonomy
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 109520700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| DUCKING, CANDACE R | Agent | 302 LAKEVIEW BLVD, WINTER HAVEN, FL 33880 |
| Name | Role | Address |
|---|---|---|
| DUCKING, CANDACE R | Manager | 302 LAKEVIEW BLVD, WINTER HAVEN, FL 33880 FL |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-10-23 |
Date of last update: 07 Feb 2025
Sources: Florida Department of State
