Provider Demographics
NPI:1982993317
Name:TRINITY HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:TRINITY HOME HEALTH SERVICES
Other - Org Name:MERCYONE DES MOINES HOME CARE
Other - Org Type:Doing Business As
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:
Practice Address - Street 1:500 SW 7TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-4506
Practice Address - Country:US
Practice Address - Phone:515-643-8383
Practice Address - Fax:515-643-0973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA100811635OtherMEDICAID WAIVER
IA1982993317Medicaid
167133Medicare Oscar/Certification