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General NPI Number Information
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NPI Number | 1023975919
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Entity Type | Organization
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Legal Business Name | TRIARK LLC
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 7951 CALUMET AVE # 1066
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City | MUNSTER
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State | IN
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Zip | 46321-1215
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Country | US
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Telephone | 708-673-3761
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Fax |
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Provider Business Mailing Address
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Address Line | 6308 PATRICIA DR
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City | MATTESON
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State | IL
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Zip | 60443-3049
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Country | US
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Telephone | 708-673-3761
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. PATRICE CLOUTIER-DAVIS
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Credential |
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Telephone | 708-673-3761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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