Provider Demographics
NPI:1902520893
Name:TRI STATE NURSING, LLC
Entity type:Organization
Organization Name:TRI STATE NURSING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-677-1117
Mailing Address - Street 1:7588 CENTRAL PARKE BLVD.
Mailing Address - Street 2:SUITE 124
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7588 CENTRAL PARKE BLVD.
Practice Address - Street 2:SUITE 124
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040
Practice Address - Country:US
Practice Address - Phone:513-677-1117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRI STATE NURSING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-04
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No385HR2050XRespite Care FacilityRespite CareRespite Care CampGroup - Multi-Specialty