Provider Demographics
NPI:1093990228
Name:TRINITY LIFE CARE, INC.
Entity Type:Organization
Organization Name:TRINITY LIFE CARE, INC.
Other - Org Name:TRINITY LIFE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/SHAREHOLDER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:MCKEE
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-893-6478
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331-0009
Mailing Address - Country:US
Mailing Address - Phone:616-691-7077
Mailing Address - Fax:616-691-1017
Practice Address - Street 1:11748 5 MILE RD NE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331-9725
Practice Address - Country:US
Practice Address - Phone:616-691-7077
Practice Address - Fax:616-691-1017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health