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General NPI Number Information
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NPI Number | 1912658261
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Entity Type | Organization
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Legal Business Name | TRI-STATE TOTAL CARE, LLC
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 02/02/2025
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Provider Practice Location Address
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Address Line | 1500 MUNFORD AVE
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City | MUNFORD
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State | TN
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Zip | 38058-0016
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Country | US
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Telephone | 901-289-2797
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Fax |
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Provider Business Mailing Address
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Address Line | 8840 RIVER RISE DR
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City | CORDOVA
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State | TN
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Zip | 38016-1628
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Country | US
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Telephone | 901-289-2797
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | JAIME TRIPP
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Credential | RN
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Telephone | 901-289-2797
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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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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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