MEDICARE: TRINITY MISSION OF COMFORT, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	116282	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285692269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY MISSION OF COMFORT, LLC

Provider Business Mailing Address
First Line	:	615 FALTIN RD
Second Line	:
City	:	COMFORT
State	:	TX
Zip	:	78013-3331
Country	:	US
Telephone Number	:	830-995-3747
Fax Number	:	830-995-3057

Provider Business Practice Location Address
First Line	:	615 FALTIN RD
Second Line	:
City	:	COMFORT
State	:	TX
Zip	:	78013-3331
Country	:	US
Telephone Number	:	830-995-3747
Fax Number	:	830-995-3057

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. CHRISTOPHER J MURPHY
Credential	:
Telephone Number	:	901-937-7994

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	04/12/2012

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