Provider Demographics
NPI:1184648842
Name:1ST TRINITY HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:1ST TRINITY HOME HEALTH CARE, INC.
Other - Org Name:TRINITY HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-665-6666
Mailing Address - Street 1:7324 SOUTHWEST FWY STE 977
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2158
Mailing Address - Country:US
Mailing Address - Phone:713-665-6666
Mailing Address - Fax:713-665-6663
Practice Address - Street 1:7324 SOUTHWEST FWY STE 977
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2158
Practice Address - Country:US
Practice Address - Phone:713-665-6666
Practice Address - Fax:713-665-6663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX006489251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001001411Medicaid
TX000127200Medicaid
TX000127200Medicaid