Organization Name: | TRINITY HOME CARE AGENCY |
NPI Number: | 1740557404 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VALETTA G CAMPBELL (OWNER/EXECTIVE) |
Mailing Address: | 1420 W Peoria Ave Suite 213 Phoenix |
State: | AZ US |
Postal Code: | 850295170 |
Phone Number: | 4802458698 |
Fax Number: | 6029434972 |
NPI Enumeration Date: | 11/23/2011 |
NPI Last Update Date: | 11/23/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | ALTP0136 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |