Provider Demographics
NPI:1508056268
Name:TRINITY ADULT MEDICAL DAYCARE INC.
Entity Type:Organization
Organization Name:TRINITY ADULT MEDICAL DAYCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:DEVEDOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-298-9800
Mailing Address - Street 1:6401 DOGWOOD ROAD, STE108
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207
Mailing Address - Country:US
Mailing Address - Phone:410-298-9800
Mailing Address - Fax:410-298-5206
Practice Address - Street 1:6200 LOCH RAVEN BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21239-1821
Practice Address - Country:US
Practice Address - Phone:410-532-3400
Practice Address - Fax:410-532-0715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care