Provider Demographics
NPI:1760711550
Name:TRINITY COMMONWEALTH GROUP LLC
Entity Type:Organization
Organization Name:TRINITY COMMONWEALTH GROUP LLC
Other - Org Name:TRINITY INTENSIVE IN-HOME SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:MS
Authorized Official - First Name:DIONE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-893-3176
Mailing Address - Street 1:1913 HUGUENOT RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4329
Mailing Address - Country:US
Mailing Address - Phone:804-893-3176
Mailing Address - Fax:
Practice Address - Street 1:1913 HUGUENOT RD
Practice Address - Street 2:SUITE 301
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4329
Practice Address - Country:US
Practice Address - Phone:804-893-3176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA128905001101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty