Provider Demographics
NPI:1205095379
Name:TRINITY ASSISTANT HOME CARE
Entity type:Organization
Organization Name:TRINITY ASSISTANT HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AID
Authorized Official - Prefix:MS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:BLOCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-340-1619
Mailing Address - Street 1:8830 CLOISTER DR APT B
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29575-4893
Mailing Address - Country:US
Mailing Address - Phone:843-340-1619
Mailing Address - Fax:
Practice Address - Street 1:8830 CLOISTER DR APT B
Practice Address - Street 2:
Practice Address - City:SURFSIDE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29575-4893
Practice Address - Country:US
Practice Address - Phone:843-340-1619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health