Provider Demographics
NPI:1144596487
Name:TRINITY FAMILY & CHILDREN SERVICES, LLC
Entity Type:Organization
Organization Name:TRINITY FAMILY & CHILDREN SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOVANDA-RAY
Authorized Official - Middle Name:ALJANIECE
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DD
Authorized Official - Phone:443-735-1457
Mailing Address - Street 1:60 RIVERCREST LN
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-5934
Mailing Address - Country:US
Mailing Address - Phone:678-308-2664
Mailing Address - Fax:
Practice Address - Street 1:60 RIVERCREST LN
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-5934
Practice Address - Country:US
Practice Address - Phone:678-308-2664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101YP1600X, 103T00000X, 172A00000X, 343900000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes347C00000XTransportation ServicesPrivate Vehicle
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)