# TRAVERSE CITY RESIDENTIA LCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356763478
- **Authorized official:** MRS. HELENA (SAM KAY EVANS CAREGIVER (OWNER OF AGENCY/MANAGER/BILLING)
- **Authorized official phone:** (231) 313-9633

## Contact information

- **Practice address:** 176 ISLAND VIEW DR, TRAVERSE CITY, MI 49696-9313
- **Practice address phone:** (231) 313-9633
- **Mailing address:** 176 ISLAND VIEW DR, TRAVERSE CITY, MI 49696-9313
- **Mailing address phone:** (231) 313-9633

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 9674527 | MI | Yes |

## Other

- **Enumeration date:** 01/08/2014
- **Last updated:** 01/08/2014