Tri-Star Residence, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

TRI-STAR RESIDENCE, LLC

Practice address

7504 W Ruby Ave
Milwaukee, WI 53218-5458

Phone

(414) 248-9239

NPI assigned

May 20, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Koua F Thao, ADMINISTRATOR

Title

Administrator

Phone

(414) 248-9239

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1437538642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7504 W RUBY AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532185458",
            "telephone_number": "414-248-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7504 W RUBY AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532185458",
            "telephone_number": "414-248-9239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STAR RESIDENCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "THAO",
        "authorized_official_first_name": "KOUA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "414-248-9239",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100014873",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Grace Trent, MSN
• Jorie Reynolds Trentadue, APNP
• Debra Lynn Tressler, RD
• Colleen M Trevino, NP
• Tri-Star Home Care, LLC
• Tribe Transportation LLC
• Sandra Trice-Allen
• Tamyra N Trice, PA-C
• Kendall Trieglaff, MD
• Denna Triggs, BA

• In Home Supportive Care Agency in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• In Home Supportive Care Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.