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General NPI Number Information
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NPI Number | 1790711398
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Entity Type | Organization
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Legal Business Name | TRI COUNTY HOSPICE
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 102 MAIN ST SUITE 304
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City | WADSWORTH
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State | OH
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Zip | 44281-1472
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Country | US
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Telephone | 330-336-6595
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Fax | 330-335-1505
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Provider Business Mailing Address
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Address Line | 102 MAIN ST SUITE 304
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City | WADSWORTH
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State | OH
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Zip | 44281-1472
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Country | US
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Telephone | 330-336-6595
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Fax | 330-335-1505
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. GREG TESNIARZ
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Credential |
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Telephone | 330-336-6595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 0078HSP
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License Number State | OH
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