Provider Demographics
NPI:1154714335
Name:TRIUMPH CARE, LLC
Entity type:Organization
Organization Name:TRIUMPH CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:FRIDAY
Authorized Official - Last Name:IDON
Authorized Official - Suffix:
Authorized Official - Credentials:LLB (HONS), BL
Authorized Official - Phone:615-586-7616
Mailing Address - Street 1:1161 MURFREESBORO PIKE STE 132
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2225
Mailing Address - Country:US
Mailing Address - Phone:615-730-6597
Mailing Address - Fax:615-730-6808
Practice Address - Street 1:1161 MURFREESBORO PIKE STE 132
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2225
Practice Address - Country:US
Practice Address - Phone:615-730-6597
Practice Address - Fax:615-730-6808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1000000013483251C00000X, 251J00000X, 251E00000X
1000000013483253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care