Provider Demographics
NPI:1336641349
Name:TRINITY HOME HEALTH, LLC.
Entity Type:Organization
Organization Name:TRINITY HOME HEALTH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:KWAME
Authorized Official - Last Name:OPPONG
Authorized Official - Suffix:
Authorized Official - Credentials:MR
Authorized Official - Phone:614-577-0766
Mailing Address - Street 1:2242 S HAMILTON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-4300
Mailing Address - Country:US
Mailing Address - Phone:614-577-0766
Mailing Address - Fax:614-577-0767
Practice Address - Street 1:2242 S HAMILTON RD STE 202
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-4300
Practice Address - Country:US
Practice Address - Phone:614-577-0766
Practice Address - Fax:614-577-0767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherDODD