Provider Demographics
NPI:1801918263
Name:TRI-COUNTY HOME SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:TRI-COUNTY HOME SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:MILTIMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-618-2390
Mailing Address - Street 1:325 CHESTNUT ST STE 800
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-2608
Mailing Address - Country:US
Mailing Address - Phone:215-618-2390
Mailing Address - Fax:215-618-2390
Practice Address - Street 1:325 CHESTNUT ST STE 800
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-2608
Practice Address - Country:US
Practice Address - Phone:215-618-2390
Practice Address - Fax:215-618-2390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101128004Medicaid