Provider Demographics
NPI:1033217856
Name:TRICOUNTY NURSES PLUS,LLC
Entity Type:Organization
Organization Name:TRICOUNTY NURSES PLUS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:MACDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:734-377-7194
Mailing Address - Street 1:410 W JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1217
Mailing Address - Country:US
Mailing Address - Phone:734-281-0695
Mailing Address - Fax:734-281-1357
Practice Address - Street 1:8538 ISLAND BLVD
Practice Address - Street 2:
Practice Address - City:GROSSE ILE
Practice Address - State:MI
Practice Address - Zip Code:48138
Practice Address - Country:US
Practice Address - Phone:734-377-7194
Practice Address - Fax:734-281-1357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703076324164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty