Provider Demographics
NPI:1053718221
Name:TRIPLE ALLIANCE ENTERPRISES, INC.
Entity type:Organization
Organization Name:TRIPLE ALLIANCE ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:LACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-791-9222
Mailing Address - Street 1:532 E LANETT DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-5068
Mailing Address - Country:US
Mailing Address - Phone:214-791-9222
Mailing Address - Fax:
Practice Address - Street 1:532 E LANETT DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-5068
Practice Address - Country:US
Practice Address - Phone:214-791-9222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRIPLE ALLIANCE ENTERPRISES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-12-03
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health