Provider Demographics
NPI:1114541729
Name:TRI MEADOWS HEALTHCARE LLC
Entity Type:Organization
Organization Name:TRI MEADOWS HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR / DPCS
Authorized Official - Prefix:
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJORADO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-818-6125
Mailing Address - Street 1:8622 RESEDA BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4094
Mailing Address - Country:US
Mailing Address - Phone:818-818-6125
Mailing Address - Fax:818-818-6173
Practice Address - Street 1:8622 RESEDA BLVD STE 204
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4094
Practice Address - Country:US
Practice Address - Phone:818-818-6125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-31
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based