- Practice location
- 1619 Diederich Blvd Ste D1, Russell, KY 41169-1778
- Phone
- 952-261-7105
- Fax
- —
- Last updated
- June 17, 2025
Tri-State Healing Initiative LLC is a healthcare organization based in Russell, KY. Tri-State Healing Initiative LLC practices in Russell, KY. The NPI Number for Tri-State Healing Initiative LLC is 1841984036. The current practice location address for Tri-State Healing Initiative LLC is 1619 Diederich Blvd Ste D1, Russell, KY 41169-1778 and can be reached out via phone at 952-261-7105.
Provider Profile Details
- NPI Number
- 1841984036
- Provider Name
- Tri-State Healing Initiative LLC
- Provider Entity Type
- Organization
- Address
- 1619 Diederich Blvd Ste D1, Russell, KY 41169-1778
- Phone Number
- 952-261-7105
- Primary Taxonomy
- Family Medicine · 207Q00000X
- Organization Subpart
- No
- Authorized Official
- Bryce Ratliff, MD · Owner · 952-261-7105
- Provider Enumeration Date
- June 8, 2023
- Last Update Date
- June 17, 2025
- Certification Date
- June 17, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1619 Diederich Blvd Ste D1
Russell, KY 41169-1778 - City
- Russell
- State
- Kentucky
- Zip
- 41169-1778
- Phone Number
- 952-261-7105
Provider Business Mailing Address Details
- Address
- 17 Lackawanna Pl Apt 318
Bloomfield, NJ 07003-2954 - City
- Bloomfield
- State
- NJ
- Zip
- 07003-2954
License Information
- Taxonomy
- Family Medicine · 207Q00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Family Medicine providers near Russell, KY
View all Family Medicine providers in Russell →Frequently Asked Questions
What is the NPI number of Tri-State Healing Initiative LLC?
The NPI number of Tri-State Healing Initiative LLC is 1841984036. It was assigned on June 8, 2023 and is currently active in the NPPES registry.
What is the specialty of Tri-State Healing Initiative LLC?
Tri-State Healing Initiative LLC is registered under the primary taxonomy Family Medicine (code 207Q00000X).
Where does Tri-State Healing Initiative LLC practice?
The practice location is 1619 Diederich Blvd Ste D1, Russell, KY 41169-1778. The office can be reached at 952-261-7105 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1841984036 directly on the NPPES registry website.