Provider Demographics
NPI:1952892721
Name:TRINITY AYOMIDE, LLC
Entity Type:Organization
Organization Name:TRINITY AYOMIDE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-997-0808
Mailing Address - Street 1:10039 BISSONNET ST STE 107
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7838
Mailing Address - Country:US
Mailing Address - Phone:713-997-0808
Mailing Address - Fax:713-903-3717
Practice Address - Street 1:10039 BISSONNET ST STE 107
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7838
Practice Address - Country:US
Practice Address - Phone:713-997-0808
Practice Address - Fax:713-903-3717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-28
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX09616066OtherDPS