Provider Demographics
NPI:1922475656
Name:TRINITY NURSING MANAGEMENT
Entity Type:Organization
Organization Name:TRINITY NURSING MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:COMFORT
Authorized Official - Middle Name:DUPE
Authorized Official - Last Name:BOGUNJOKO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MSC
Authorized Official - Phone:240-354-1632
Mailing Address - Street 1:12217 KINGS ARROW ST
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1943
Mailing Address - Country:US
Mailing Address - Phone:240-354-1632
Mailing Address - Fax:240-245-3910
Practice Address - Street 1:12217 KINGS ARROW ST
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1943
Practice Address - Country:US
Practice Address - Phone:240-354-1632
Practice Address - Fax:240-245-3910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1003995251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management