Provider Demographics
NPI:1790975357
Name:TRINITY ICF/MR, INC.
Entity Type:Organization
Organization Name:TRINITY ICF/MR, INC.
Other - Org Name:TRINITY MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRES.
Authorized Official - Prefix:MR
Authorized Official - First Name:ALTON
Authorized Official - Middle Name:G
Authorized Official - Last Name:SPEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-202-9700
Mailing Address - Street 1:2813 COUNTRY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1121
Mailing Address - Country:US
Mailing Address - Phone:972-202-9700
Mailing Address - Fax:972-202-9703
Practice Address - Street 1:2813 COUNTRY VALLEY RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1121
Practice Address - Country:US
Practice Address - Phone:972-202-9700
Practice Address - Fax:972-202-9703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007404315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities