Healthcare Provider Details
I. General information
NPI: 1770737728
Provider Name (Legal Business Name): TRIGG COUNTY HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/04/2008
Last Update Date: 01/13/2022
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
72 LONE OAK DR
CADIZ KY
42211-6520
US
IV. Provider business mailing address
PO BOX 51266
LAFAYETTE LA
70505-1266
US
V. Phone/Fax
- Phone: 270-522-0488
- Fax: 270-522-0489
- Phone: 337-233-1307
- Fax: 337-443-4154
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 150167 |
| License Number State | KY |
VIII. Authorized Official
Name:
NICHOLAS
GACHASSIN
III
Title or Position: SECRETARY/TREASURER
Credential:
Phone: 337-233-1307