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Organization

TRISOUTH CAP SERVICES

Active
Parent organization
TRISOUTH HEALTH SERVICES, INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
TRISOUTH HEALTH SERVICES, INC
Authorized official
VERONICA SOUTHERLAND RN, BSW (ADMINISTRATOR)
(704) 493-3422
Entity
Organization

Contact information

Practice address
756 TYVOLA RD, SUITE 143, CHARLOTTE, NC 28217-3588
(704) 525-2505
(704) 525-2506
Mailing address
PO BOX 242036, CHARLOTTE, NC 28224-2036
(704) 525-2505
(704) 525-2506

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC3525
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3418482
NC
Enumeration date
05/07/2009
Last updated
05/07/2009
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