Provider Demographics
NPI:1972232957
Name:TROUTMAN ENTERPRISES, LLC
Entity Type:Organization
Organization Name:TROUTMAN ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-593-2789
Mailing Address - Street 1:1331 N STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-2239
Mailing Address - Country:US
Mailing Address - Phone:417-593-2789
Mailing Address - Fax:
Practice Address - Street 1:1331 N STEWART AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-2239
Practice Address - Country:US
Practice Address - Phone:417-593-2789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARING COMPANIONS IN-HOME SENIOR CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1Medicaid