Provider Demographics
NPI:1275199614
Name:TRINITY NATIONWIDE RECOVERY, INC
Entity Type:Organization
Organization Name:TRINITY NATIONWIDE RECOVERY, INC
Other - Org Name:TRINITY BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:VILLA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:714-589-9228
Mailing Address - Street 1:11827 LOWEMONT ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-6517
Mailing Address - Country:US
Mailing Address - Phone:714-589-9228
Mailing Address - Fax:714-276-9611
Practice Address - Street 1:12433 LAMBERT RD STE A&B
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2770
Practice Address - Country:US
Practice Address - Phone:844-887-4648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-10
Last Update Date:2023-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder