Provider Demographics
NPI:1518368927
Name:TRINITY HEALTH CARE SERVICES, INC
Entity Type:Organization
Organization Name:TRINITY HEALTH CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-986-1754
Mailing Address - Street 1:3951 N HAVERHILL RD
Mailing Address - Street 2:SUITE 202-204
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-8349
Mailing Address - Country:US
Mailing Address - Phone:561-471-7676
Mailing Address - Fax:561-471-8485
Practice Address - Street 1:3951 N HAVERHILL RD
Practice Address - Street 2:SUITE 202-204
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-8349
Practice Address - Country:US
Practice Address - Phone:954-986-1754
Practice Address - Fax:954-986-1757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991435251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL651039600Medicaid
FL108081Medicare Oscar/Certification