MEDICARE: TRI-STATE HOME CARE AGENCY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1396685921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI-STATE HOME CARE AGENCY LLC

Provider Business Mailing Address
First Line	:	915 W ALTA VISTA RD APT 3050
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-5655
Country	:	US
Telephone Number	:	202-322-8157
Fax Number	:

Provider Business Practice Location Address
First Line	:	915 W ALTA VISTA RD APT 3050
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-5655
Country	:	US
Telephone Number	:	202-322-8157
Fax Number	:

Authorized Official
Title or Position	:	MANAGING OWNER
Name	:	MR. ZEZE RWASAMA
Credential	:
Telephone Number	:	202-322-8157

Provider Enumeration Date	:	04/01/2026
Last Update Date	:	04/01/2026

Similar Medicare Providers

1447190723 — SHIFT MED TRANS LLC
Practice Location Address:

7004 S 38TH LN
PHOENIX, AZ
85041-7500

Practice Phone: 480-702-5201
Practice Fax:

1932049608 — FAMILIES PROSPER LLC
Practice Location Address:

5906 S 16TH DR
PHOENIX, AZ
85041-4646

Practice Phone: 773-516-7312
Practice Fax:

1093654824 — MARIE HORTENSE TIOKOU PMHNP
Practice Location Address:

6812 S 21ST DR
PHOENIX, AZ
85041-6561

Practice Phone: 480-284-9638
Practice Fax: 602-429-8148

1699614255 — GRACE ODIGIE
Practice Location Address:

316 W BROADWAY RD
PHOENIX, AZ
85041-0060

Practice Phone: 623-275-6473
Practice Fax:

1326987918 — AMELIA YOUNG
Practice Location Address:

234 W SOUTHERN AVE
PHOENIX, AZ
85041-4845

Practice Phone: 480-547-6942
Practice Fax:

1952249195 — SOUTHERN DENTAL LLC
Practice Location Address:

3320 W SOUTHERN AVE STE 111
PHOENIX, AZ
85041-4307

Practice Phone: 630-699-3744
Practice Fax:

Directions to “TRI-STATE HOME CARE AGENCY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.