Provider Demographics
NPI:1083088603
Name:TRINITY HOME CARE
Entity Type:Organization
Organization Name:TRINITY HOME CARE
Other - Org Name:TRINITY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:VALETTA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-783-3624
Mailing Address - Street 1:4802 N 12TH ST
Mailing Address - Street 2:SUITE 2043
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-4051
Mailing Address - Country:US
Mailing Address - Phone:602-783-3624
Mailing Address - Fax:602-956-2111
Practice Address - Street 1:4802 N 12TH ST
Practice Address - Street 2:SUITE 2043
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4051
Practice Address - Country:US
Practice Address - Phone:602-783-3624
Practice Address - Fax:602-956-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health