Provider Demographics
NPI:1720822190
Name:TRIBE HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:TRIBE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DJOMGOUE
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MBA
Authorized Official - Phone:410-992-2528
Mailing Address - Street 1:5465 VANTAGE POINT RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2630
Mailing Address - Country:US
Mailing Address - Phone:410-992-2529
Mailing Address - Fax:
Practice Address - Street 1:250 E 5TH ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-4119
Practice Address - Country:US
Practice Address - Phone:410-992-2529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care