Provider Demographics
NPI:1629195094
Name:TRI-VALLEY, INC
Entity Type:Organization
Organization Name:TRI-VALLEY, INC
Other - Org Name:TRI-VALLEY ELDER SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:TRAVINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-949-6640
Mailing Address - Street 1:10 MILL ST
Mailing Address - Street 2:
Mailing Address - City:DUDLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01571-3377
Mailing Address - Country:US
Mailing Address - Phone:508-949-6640
Mailing Address - Fax:508-949-6651
Practice Address - Street 1:10 MILL ST
Practice Address - Street 2:
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571-3377
Practice Address - Country:US
Practice Address - Phone:508-949-6640
Practice Address - Fax:508-949-6651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1948491Medicaid