Provider Demographics
NPI:1265891402
Name:TRINITY CARE OF OHIO, LLC
Entity type:Organization
Organization Name:TRINITY CARE OF OHIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:FADER
Authorized Official - Suffix:
Authorized Official - Credentials:IMFT
Authorized Official - Phone:702-810-5940
Mailing Address - Street 1:122 W FRONT ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1467
Mailing Address - Country:US
Mailing Address - Phone:702-810-5940
Mailing Address - Fax:
Practice Address - Street 1:122 W FRONT ST
Practice Address - Street 2:SUITE D
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1467
Practice Address - Country:US
Practice Address - Phone:702-810-5940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF15000022106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty