Provider Demographics
NPI:1740598127
Name:TRINITY TRANSITIONAL CARE
Entity Type:Organization
Organization Name:TRINITY TRANSITIONAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:JANET
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-266-7845
Mailing Address - Street 1:PO BOX 50322
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76105-0322
Mailing Address - Country:US
Mailing Address - Phone:864-266-7845
Mailing Address - Fax:
Practice Address - Street 1:3509 RICHARDSON CT
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76119-1713
Practice Address - Country:US
Practice Address - Phone:864-266-7845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-19
Last Update Date:2010-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children