Provider Demographics
NPI:1366033276
Name:TRINE HOME CARE
Entity Type:Organization
Organization Name:TRINE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAVON
Authorized Official - Middle Name:DARNELL
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-535-8577
Mailing Address - Street 1:6725 DALY RD UNIT 250275
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48325-3213
Mailing Address - Country:US
Mailing Address - Phone:248-535-8577
Mailing Address - Fax:
Practice Address - Street 1:8044 ORION ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-3647
Practice Address - Country:US
Practice Address - Phone:248-535-8577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health