Provider Demographics
NPI:1952483687
Name:TRINITY HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:TRINITY HOME HEALTH SERVICES
Other - Org Name:HOLY CROSS HOME HEALTH, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-283-4006
Mailing Address - Street 1:5601 N DIXIE HWY
Mailing Address - Street 2:SUIT 208
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4145
Mailing Address - Country:US
Mailing Address - Phone:954-267-7000
Mailing Address - Fax:954-776-6972
Practice Address - Street 1:5601 N DIXIE HWY
Practice Address - Street 2:SUITE #208
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-4145
Practice Address - Country:US
Practice Address - Phone:954-267-7000
Practice Address - Fax:954-776-6972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20472096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH51OtherBCBS PROVIDER #
FL650104400Medicaid
FL107362Medicare PIN