Provider Demographics
NPI:1043616113
Name:1 TRINITY'S PLACE
Entity Type:Organization
Organization Name:1 TRINITY'S PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYTRIANA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:972-814-3573
Mailing Address - Street 1:PO BOX 1718
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75123-1718
Mailing Address - Country:US
Mailing Address - Phone:972-814-3573
Mailing Address - Fax:214-374-5683
Practice Address - Street 1:2209 INCA DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7126
Practice Address - Country:US
Practice Address - Phone:972-814-3573
Practice Address - Fax:214-374-5683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility