Provider Demographics
NPI:1578060521
Name:SOUND OF TRIUMPH HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:SOUND OF TRIUMPH HOME CARE AGENCY LLC
Other - Org Name:BRIDGETT R. BRADLEY ENTERPRISES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-318-6967
Mailing Address - Street 1:PO BOX 343168
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38184-3168
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1674 DELANO AVE UNIT 233
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38127-8515
Practice Address - Country:US
Practice Address - Phone:901-631-1940
Practice Address - Fax:901-347-1259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251J00000X, 385H00000X
TNI000000022060253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No385H00000XRespite Care FacilityRespite Care