Healthcare Provider Details

I. General information

NPI: 1962115725
Provider Name (Legal Business Name): TRIEFA HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2022
Last Update Date: 12/26/2022
Certification Date: 12/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 GROVE ST
WORCESTER MA
01605-3936
US

IV. Provider business mailing address

324 GROVE ST
WORCESTER MA
01605-3936
US

V. Phone/Fax

Practice location:
  • Phone: 774-268-8692
  • Fax: 774-220-5689
Mailing address:
  • Phone: 774-268-8692
  • Fax: 774-220-5689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: FUNMI EDEBIRI
Title or Position: MANAGER
Credential:
Phone: 774-268-8692