Provider Demographics
NPI:1881044790
Name:TRINITY CARE LLC
Entity Type:Organization
Organization Name:TRINITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COA
Authorized Official - Prefix:MR
Authorized Official - First Name:CE-DRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LSATP
Authorized Official - Phone:843-617-0966
Mailing Address - Street 1:6542 W JUNALUSKA DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-2220
Mailing Address - Country:US
Mailing Address - Phone:843-617-0966
Mailing Address - Fax:
Practice Address - Street 1:6542 W JUNALUSKA DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-2220
Practice Address - Country:US
Practice Address - Phone:843-617-0966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-21
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health