Provider Demographics
NPI:1548590136
Name:TAHOE TRIO LLC DBA RIGHT AT HOME
Entity Type:Organization
Organization Name:TAHOE TRIO LLC DBA RIGHT AT HOME
Other - Org Name:RIGHT AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:JEFFERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-466-5472
Mailing Address - Street 1:9375 ARCHIBALD AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5729
Mailing Address - Country:US
Mailing Address - Phone:909-466-5472
Mailing Address - Fax:909-466-5874
Practice Address - Street 1:9375 ARCHIBALD AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5729
Practice Address - Country:US
Practice Address - Phone:909-466-5472
Practice Address - Fax:909-466-5874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care