Provider Demographics
NPI:1417431495
Name:TRINITY TREATMENT CENTER
Entity Type:Organization
Organization Name:TRINITY TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IVANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANINOCENCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-710-6520
Mailing Address - Street 1:1030 SKYLINE DR APT 21
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-6142
Mailing Address - Country:US
Mailing Address - Phone:978-710-6520
Mailing Address - Fax:
Practice Address - Street 1:1030 SKYLINE DR APT 21
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-6142
Practice Address - Country:US
Practice Address - Phone:978-710-6520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty