MEDICARE: TRIBE HEALTH SERVICES, 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1720822190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIBE HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	5465 VANTAGE POINT RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2630
Country	:	US
Telephone Number	:	410-992-2529
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 E 5TH ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-4119
Country	:	US
Telephone Number	:	410-992-2529
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LEONARD DJOMGOUE
Credential	:	BA, MBA
Telephone Number	:	410-992-2528

Provider Enumeration Date	:	06/20/2024
Last Update Date	:	06/20/2024

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Directions to “TRIBE HEALTH SERVICES, LLC ” Practice Location

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