Healthcare Provider Details

I. General information

NPI: 1205661154
Provider Name (Legal Business Name): TRY US HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2024
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 18TH PL SE
LAKE STEVENS WA
98258-3160
US

IV. Provider business mailing address

7010 18TH PL SE
LAKE STEVENS WA
98258-3160
US

V. Phone/Fax

Practice location:
  • Phone: 985-415-2056
  • Fax:
Mailing address:
  • Phone: 985-415-2056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name: LILLIAN KIRUNGI
Title or Position: MEMBER/ CARE COORDINATOR
Credential:
Phone: 425-399-6821