Provider Demographics
NPI:1750564456
Name:TRINITYCARE, LLC
Entity type:Organization
Organization Name:TRINITYCARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE & ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:MCGRATH
Authorized Official - Last Name:CHRIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-345-2000
Mailing Address - Street 1:18440 ROSCOE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4107
Mailing Address - Country:US
Mailing Address - Phone:866-638-3203
Mailing Address - Fax:818-718-8985
Practice Address - Street 1:18440 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4107
Practice Address - Country:US
Practice Address - Phone:866-638-3203
Practice Address - Fax:818-718-8985
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITYCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-17
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHL0434Medicaid
CAHL0434Medicaid