Healthcare Provider Details

I. General information

NPI: 1740095843
Provider Name (Legal Business Name): T.R.I.P. COMMUNITY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4661 GILHOUSE RD
TOLEDO OH
43623-2043
US

IV. Provider business mailing address

4661 GILHOUSE RD
TOLEDO OH
43623-2043
US

V. Phone/Fax

Practice location:
  • Phone: 419-277-1770
  • Fax:
Mailing address:
  • Phone: 419-277-1770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: TRESSIE MACK
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 419-277-1770