Provider Demographics
NPI:1407276231
Name:TRIUMPH CARE, LLC
Entity Type:Organization
Organization Name:TRIUMPH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHAIRPERSON
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:FRIDAY
Authorized Official - Last Name:IDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-586-7616
Mailing Address - Street 1:3044 SUMMERCREST TRL
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-1184
Mailing Address - Country:US
Mailing Address - Phone:615-586-7616
Mailing Address - Fax:615-984-3045
Practice Address - Street 1:3044 SUMMERCREST TRL
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-1184
Practice Address - Country:US
Practice Address - Phone:615-586-7616
Practice Address - Fax:615-984-3045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-19
Last Update Date:2014-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN179761253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care