Provider Demographics
NPI:1063009132
Name:TRIUMPHANT CARE LIMITED
Entity Type:Organization
Organization Name:TRIUMPHANT CARE LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:TACHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-655-1502
Mailing Address - Street 1:6660 DIXIE HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-2237
Mailing Address - Country:US
Mailing Address - Phone:513-655-1502
Mailing Address - Fax:
Practice Address - Street 1:6660 DIXIE HWY STE 202
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-2237
Practice Address - Country:US
Practice Address - Phone:513-655-1502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0363160Medicaid