| Organization Name: | IN-HOME CARE OF THE TRIAD, LLC |
| NPI Number: | 1104105188 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUSSELL Y THOMAS (PRESIDENT & CEO) |
| Mailing Address: | 125 S Main St Kernersville |
| State: | NC US |
| Postal Code: | 272842757 |
| Phone Number: | 3363100770 |
| Fax Number: | |
| NPI Enumeration Date: | 08/09/2011 |
| NPI Last Update Date: | 08/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | HC4374 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |