Provider Demographics
NPI:1437283926
Name:TRINITY HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:TRINITY HEALTH CENTER, LLC
Other - Org Name:TRINITY ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:HAWBAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:970-375-2273
Mailing Address - Street 1:3438 COUNTY ROAD 122
Mailing Address - Street 2:
Mailing Address - City:HESPERUS
Mailing Address - State:CO
Mailing Address - Zip Code:81326-8500
Mailing Address - Country:US
Mailing Address - Phone:970-375-2273
Mailing Address - Fax:
Practice Address - Street 1:1 MERCADO ST
Practice Address - Street 2:SUITE 150
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7300
Practice Address - Country:US
Practice Address - Phone:970-375-2273
Practice Address - Fax:970-375-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO928171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty