Provider Demographics
NPI:1114225364
Name:EDWARDS-TRINITY HEALTHCARE, INC.
Entity Type:Organization
Organization Name:EDWARDS-TRINITY HEALTHCARE, INC.
Other - Org Name:TRINITY HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAULLY
Authorized Official - Middle Name:N
Authorized Official - Last Name:OKEA
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:214-622-2513
Mailing Address - Street 1:9696 SKILLMAN ST
Mailing Address - Street 2:STE. 225
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-8264
Mailing Address - Country:US
Mailing Address - Phone:214-622-2513
Mailing Address - Fax:214-553-5138
Practice Address - Street 1:9696 SKILLMAN ST
Practice Address - Street 2:STE. 225
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-8264
Practice Address - Country:US
Practice Address - Phone:214-622-2513
Practice Address - Fax:214-553-5138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011348251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health