Provider Demographics
NPI:1619362431
Name:TRINITY INTEGRATE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:TRINITY INTEGRATE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHACKQUIEL
Authorized Official - Middle Name:MESHAWN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:318-507-8185
Mailing Address - Street 1:3257 BERT KOUN LOOP APT 19106
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-2982
Mailing Address - Country:US
Mailing Address - Phone:318-507-8185
Mailing Address - Fax:
Practice Address - Street 1:3257 BERT KOUN LOOP APT 19106
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-2982
Practice Address - Country:US
Practice Address - Phone:318-507-8185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care