Provider Demographics
NPI:1457921066
Name:TRUST HEALING & RELIABLE NURSE REGISTRY, INC.
Entity Type:Organization
Organization Name:TRUST HEALING & RELIABLE NURSE REGISTRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RECHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAKEMORE-GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-609-1083
Mailing Address - Street 1:3800 INVERRARY BLVD STE 400H
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4359
Mailing Address - Country:US
Mailing Address - Phone:786-545-6077
Mailing Address - Fax:954-252-4702
Practice Address - Street 1:3800 INVERRARY BLVD STE 400H
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4359
Practice Address - Country:US
Practice Address - Phone:786-545-6077
Practice Address - Fax:954-252-4702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-26
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30212588OtherAHCA LICENSE