Provider Demographics
NPI:1801208640
Name:TRYSAIL FLHC HOLDINGS LLC
Entity Type:Organization
Organization Name:TRYSAIL FLHC HOLDINGS LLC
Other - Org Name:FIRSTLIGHT HOMECARE OF SOUTHERN PALM BEACH CO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:H
Authorized Official - Last Name:RUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-271-4644
Mailing Address - Street 1:80 NE 4TH AVE
Mailing Address - Street 2:SUITE 28
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4564
Mailing Address - Country:US
Mailing Address - Phone:561-271-4644
Mailing Address - Fax:831-851-1876
Practice Address - Street 1:80 NE 4TH AVE
Practice Address - Street 2:SUITE 28
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4564
Practice Address - Country:US
Practice Address - Phone:561-271-4644
Practice Address - Fax:831-851-1876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
FL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015845500Medicaid