Provider Demographics
NPI:1063681625
Name:TRINITY SERVICES INC.
Entity Type:Organization
Organization Name:TRINITY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-320-7190
Mailing Address - Street 1:301 VETERANS PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-2899
Mailing Address - Country:US
Mailing Address - Phone:815-485-6197
Mailing Address - Fax:
Practice Address - Street 1:27655 S GOUGAR RD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:IL
Practice Address - Zip Code:60442-9309
Practice Address - Country:US
Practice Address - Phone:815-478-7559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-27
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health