Provider Demographics
NPI:1174520290
Name:TRIUMPH HOME HEALTH CARE INC
Entity type:Organization
Organization Name:TRIUMPH HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOUG
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:248-426-9714
Mailing Address - Street 1:19900 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1409
Mailing Address - Country:US
Mailing Address - Phone:248-426-9714
Mailing Address - Fax:248-426-9745
Practice Address - Street 1:19900 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1409
Practice Address - Country:US
Practice Address - Phone:248-426-9714
Practice Address - Fax:248-426-9745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237475Medicare ID - Type Unspecified