Provider Demographics
NPI:1902541626
Name:TRIUMPH SENIOR CARE LLC
Entity Type:Organization
Organization Name:TRIUMPH SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JASMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-561-3877
Mailing Address - Street 1:215 N ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-5003
Mailing Address - Country:US
Mailing Address - Phone:219-210-1888
Mailing Address - Fax:
Practice Address - Street 1:215 N ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-5003
Practice Address - Country:US
Practice Address - Phone:219-210-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care