Provider Demographics
NPI:1336421072
Name:TRINITY HOME HEALTH LLC
Entity Type:Organization
Organization Name:TRINITY HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELOS REYES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:562-472-6845
Mailing Address - Street 1:17316 EDWARDS RD
Mailing Address - Street 2:#260
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2446
Mailing Address - Country:US
Mailing Address - Phone:562-404-6500
Mailing Address - Fax:562-404-7755
Practice Address - Street 1:17316 EDWARDS RD
Practice Address - Street 2:#260
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-2446
Practice Address - Country:US
Practice Address - Phone:562-404-6500
Practice Address - Fax:562-404-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA201018010011251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health