Provider Demographics
NPI:1497394787
Name:TRINITY HEALTHY LIVING LLC
Entity Type:Organization
Organization Name:TRINITY HEALTHY LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-608-3322
Mailing Address - Street 1:58 E MAIN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-4988
Mailing Address - Country:US
Mailing Address - Phone:401-608-3322
Mailing Address - Fax:401-608-3323
Practice Address - Street 1:58 E MAIN RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-4988
Practice Address - Country:US
Practice Address - Phone:401-608-3322
Practice Address - Fax:401-608-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty