Provider Demographics
NPI:1790463677
Name:TRINITY CARE ADHC, INC.
Entity Type:Organization
Organization Name:TRINITY CARE ADHC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PADOR
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:310-941-3302
Mailing Address - Street 1:43428 COTTAGE LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-5474
Mailing Address - Country:US
Mailing Address - Phone:310-941-3302
Mailing Address - Fax:661-840-5933
Practice Address - Street 1:15862 K ST
Practice Address - Street 2:
Practice Address - City:MOJAVE
Practice Address - State:CA
Practice Address - Zip Code:93501-1711
Practice Address - Country:US
Practice Address - Phone:888-575-5048
Practice Address - Fax:661-840-5933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health