Provider Demographics
NPI:1639456387
Name:TRINITY
Entity Type:Organization
Organization Name:TRINITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOME HEALTH AID
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIKA
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-531-2866
Mailing Address - Street 1:19500 LAKE SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44119-1062
Mailing Address - Country:US
Mailing Address - Phone:330-519-0390
Mailing Address - Fax:
Practice Address - Street 1:19500 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-1062
Practice Address - Country:US
Practice Address - Phone:330-519-0390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health