Provider Demographics
NPI:1861814113
Name:TRINITY HEALTHCARE STAFFING INC
Entity Type:Organization
Organization Name:TRINITY HEALTHCARE STAFFING INC
Other - Org Name:TRINITY PRIVATE HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-227-9222
Mailing Address - Street 1:625 CARVER RD
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-3937
Mailing Address - Country:US
Mailing Address - Phone:770-227-9222
Mailing Address - Fax:770-227-9009
Practice Address - Street 1:121 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4220
Practice Address - Country:US
Practice Address - Phone:770-227-9222
Practice Address - Fax:770-227-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA126-R0008253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA903628942AMedicaid