1023018975 NPI number — TRINITY HEALTH AND HOME CARE SERVICES, LLC

Table of content: (NPI 1023018975)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023018975 NPI number — TRINITY HEALTH AND HOME CARE SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRINITY HEALTH AND HOME CARE SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TRINITY HEALTH AND HOME CARE SERVICES
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023018975
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 171817
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76003-1817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-782-9190
Provider Business Mailing Address Fax Number:
817-585-4806

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2720 STAIN GLASS CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARROLLTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75007-5052
Provider Business Practice Location Address Country Code:
UM
Provider Business Practice Location Address Telephone Number:
972-782-9190
Provider Business Practice Location Address Fax Number:
817-585-4806
Provider Enumeration Date:
07/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MWESIGWA
Authorized Official First Name:
ISRAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
ALT ADMINISTRATOR
Authorized Official Telephone Number:
214-263-2389

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  008318 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010325 . This is a "HCSSA LICENSE NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 181836101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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