Provider Demographics
NPI:1770009979
Name:TRINITY-FPACP PECOS LLC
Entity Type:Organization
Organization Name:TRINITY-FPACP PECOS LLC
Other - Org Name:FOCUSED CARE AT PECOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:JAIMIE
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-632-1000
Mailing Address - Street 1:1401 BALLINGER ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-5903
Mailing Address - Country:US
Mailing Address - Phone:817-632-1000
Mailing Address - Fax:817-632-1001
Practice Address - Street 1:1819 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PECOS
Practice Address - State:TX
Practice Address - Zip Code:79772-7036
Practice Address - Country:US
Practice Address - Phone:432-447-2183
Practice Address - Fax:432-447-6815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility