Provider Demographics
NPI:1760076111
Name:TRINITY SUPPORT CARE
Entity Type:Organization
Organization Name:TRINITY SUPPORT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUWATIMILEHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEDOKUN
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:856-519-8613
Mailing Address - Street 1:625 STOCKTON DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-1988
Mailing Address - Country:US
Mailing Address - Phone:856-519-8613
Mailing Address - Fax:
Practice Address - Street 1:625 STOCKTON DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08094-1988
Practice Address - Country:US
Practice Address - Phone:856-519-8613
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health