Provider Demographics
NPI:1285699058
Name:TRI-COUNTY HOMECARE, LLC
Entity type:Organization
Organization Name:TRI-COUNTY HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:DENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-962-6946
Mailing Address - Street 1:30700 TELEGRAPH RD
Mailing Address - Street 2:SUITE 1540
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4524
Mailing Address - Country:US
Mailing Address - Phone:313-962-6946
Mailing Address - Fax:313-962-8288
Practice Address - Street 1:30700 TELEGRAPH RD
Practice Address - Street 2:SUITE 1540
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4524
Practice Address - Country:US
Practice Address - Phone:313-962-6946
Practice Address - Fax:313-962-8288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
237520Medicare ID - Type Unspecified