Provider Demographics
NPI:1093746562
Name:TRINITY HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:TRINITY HOME HEALTH SERVICES
Other - Org Name:SAINT JOSEPH VNA HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-283-4006
Mailing Address - Street 1:PO BOX 532020
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48153-2020
Mailing Address - Country:US
Mailing Address - Phone:877-827-0788
Mailing Address - Fax:734-343-6451
Practice Address - Street 1:707 CEDAR ST STE 320
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-2054
Practice Address - Country:US
Practice Address - Phone:574-335-8600
Practice Address - Fax:574-335-0751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN0007931770OtherAETNA
IN021236800OtherDEPT OF LABOR BLACK LUNG
IN202117OtherCSHCS - PLYMOUTH OFFICE
IN351568821-003OtherHUMANA
IN202118OtherCSHCS - MISHAWAKA OFFICE
IN000000355403OtherANTHEM BLUE CROSS BLUE SH
IN100272270AMedicaid
IN000000355403OtherANTHEM BLUE CROSS BLUE SH
IN202118OtherCSHCS - MISHAWAKA OFFICE