Provider Demographics
NPI:1790393361
Name:TRIAD HOME HEALTH SOLUTIONS LLC
Entity Type:Organization
Organization Name:TRIAD HOME HEALTH SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRILYNN
Authorized Official - Middle Name:KNYKOLE
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-598-6940
Mailing Address - Street 1:15510 JOST CIR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-3457
Mailing Address - Country:US
Mailing Address - Phone:314-598-6940
Mailing Address - Fax:
Practice Address - Street 1:15510 JOST CIR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-3457
Practice Address - Country:US
Practice Address - Phone:314-598-6940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health