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General NPI Number Information
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NPI Number | 1043763907
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Entity Type | Organization
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Legal Business Name | TRI STATE HOME CARE SERVICES, LLC
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 128 PRESIDENTS ST
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City | FORT ASHBY
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State | WV
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Zip | 26719-0017
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Country | US
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Telephone | 558-813-1332
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Fax | 304-298-3435
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Provider Business Mailing Address
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Address Line | PO BOX 17
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City | FORT ASHBY
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State | WV
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Zip | 26719-0017
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Country | US
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Telephone | 304-298-3434
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DONALD KYLE HARRIS II
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Credential |
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Telephone | 855-813-1332
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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