Provider Demographics
NPI:1376676973
Name:TRINITY YOUTH SERVICES
Entity Type:Organization
Organization Name:TRINITY YOUTH SERVICES
Other - Org Name:TRINITY MONTEREY PARK
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:IV
Authorized Official - Credentials:MA
Authorized Official - Phone:714-713-0561
Mailing Address - Street 1:PO BOX 1210
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-1210
Mailing Address - Country:US
Mailing Address - Phone:714-713-0561
Mailing Address - Fax:909-825-5340
Practice Address - Street 1:1000 CORPORATE CENTER DR STE 650
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-7639
Practice Address - Country:US
Practice Address - Phone:626-966-1776
Practice Address - Fax:626-266-5780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2021-02-08
Deactivation Date:2012-09-11
Deactivation Code:
Reactivation Date:2012-10-24
Provider Licenses
StateLicense IDTaxonomies
CA7552A261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health