Provider Demographics
NPI:1396389193
Name:TRI-CHIPA HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:TRI-CHIPA HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PROSPER
Authorized Official - Middle Name:IKECHUKWU
Authorized Official - Last Name:IGBOELI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-380-6978
Mailing Address - Street 1:1417 AYLESBURY DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-8214
Mailing Address - Country:US
Mailing Address - Phone:706-380-6978
Mailing Address - Fax:
Practice Address - Street 1:1417 AYLESBURY DR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-8214
Practice Address - Country:US
Practice Address - Phone:706-380-6978
Practice Address - Fax:762-222-7421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health