Provider Demographics
NPI:1649612524
Name:TRICO CLINICAL SERVICES LTD
Entity type:Organization
Organization Name:TRICO CLINICAL SERVICES LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HELGA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HERTLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-862-4961
Mailing Address - Street 1:PO BOX 826
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-0826
Mailing Address - Country:US
Mailing Address - Phone:301-862-4961
Mailing Address - Fax:
Practice Address - Street 1:46940 S SHANGRI LA DR
Practice Address - Street 2:SUITE 10
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-1037
Practice Address - Country:US
Practice Address - Phone:301-862-4961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child