Provider Demographics
NPI:1649244401
Name:TRINITY HOME HEALTH SERVICES
Entity type:Organization
Organization Name:TRINITY HOME HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-283-4006
Mailing Address - Street 1:PO BOX 532020
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48153-2020
Mailing Address - Country:US
Mailing Address - Phone:877-827-0788
Mailing Address - Fax:734-343-6451
Practice Address - Street 1:801 5TH ST
Practice Address - Street 2:STE 320
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1326
Practice Address - Country:US
Practice Address - Phone:712-233-5100
Practice Address - Fax:712-233-5102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-16
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA67073OtherBCBS
IA0670737Medicaid
IA383320705OtherCOMMERCIAL INSURANCE
NE38332070501Medicaid
IA167073Medicare Oscar/Certification