MEDICARE: TRIPPLE CROSS HOME HEALTH CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154815488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIPPLE CROSS HOME HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	4020 N VALLEY DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-6844
Country	:	US
Telephone Number	:	575-571-2724
Fax Number	:

Provider Business Practice Location Address
First Line	:	4020 N VALLEY DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-6844
Country	:	US
Telephone Number	:	575-571-2724
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. JACQUELINE M MERAZ
Credential	:
Telephone Number	:	575-571-2724

Provider Enumeration Date	:	06/20/2018
Last Update Date	:	06/20/2018

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