Provider Demographics
NPI:1265483051
Name:TRINITY MISSION NEW PARIS RESIDENTIAL CARE FACILITY, LP
Entity type:Organization
Organization Name:TRINITY MISSION NEW PARIS RESIDENTIAL CARE FACILITY, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-937-7994
Mailing Address - Street 1:7739 US HIGHWAY 40
Mailing Address - Street 2:
Mailing Address - City:NEW PARIS
Mailing Address - State:OH
Mailing Address - Zip Code:45347-9048
Mailing Address - Country:US
Mailing Address - Phone:937-437-2311
Mailing Address - Fax:937-437-3508
Practice Address - Street 1:7739 US HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:NEW PARIS
Practice Address - State:OH
Practice Address - Zip Code:45347-9048
Practice Address - Country:US
Practice Address - Phone:937-437-2311
Practice Address - Fax:937-437-3508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1035N315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1404555Medicaid