Organization
TRI-CARE HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE MISHONDA BLUE (AGENCY DIRECTOR)
(910) 299-5161
Entity
Organization
Contact information
Practice address
166 LIVINGSTON LN, CLINTON, NC 28328-1513
(910) 299-5161
Mailing address
166 LIVINGSTON LN, CLINTON, NC 28328-1513
(910) 299-5161
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
6601535
NC
Other
Enumeration date
11/16/2006
Last updated
08/22/2020
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