Tri State Home Care Services, LLC

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Legal business name

TRI STATE HOME CARE SERVICES, LLC

Practice address

128 Presidents St
Fort Ashby, WV 26719-0017

Phone

(558) 813-1332

Fax

(304) 298-3435

NPI assigned

Jul 27, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donald Kyle Harris II

Title

Owner

Phone

(855) 813-1332

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1043763907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17",
            "city": "FORT ASHBY",
            "state": "WV",
            "postal_code": "267190017",
            "telephone_number": "304-298-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 PRESIDENTS ST",
            "city": "FORT ASHBY",
            "state": "WV",
            "postal_code": "267190017",
            "telephone_number": "558-813-1332",
            "fax_number": "304-298-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI STATE HOME CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-27",
        "last_updated": "2025-09-11",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-813-1332",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043763907",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "9864.axiscare.com",
            "affiliation": "N",
            "endpointDescription": "Hosting CRM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Virtu Encyption Service",
            "address_1": "128 Presidents St",
            "city": "Fort Ashby",
            "state": "WV",
            "country_code": "US",
            "postal_code": "267190017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Personal Care Attendant in Fort Ashby, WV
• Providers in Fort Ashby, WV by specialty
• Personal Care Attendant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.