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NPI Code Detail

MEDICARE: TRINITY SERVICES INC.

MEDICARE: TRINITY SERVICES INC.
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1760091508
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRINITY SERVICES INC.
Provider Business Mailing Address
First Line : 301 VETERANS PKWY
Second Line :
City : NEW LENOX
State : IL
Zip : 60451-2899
Country : US
Telephone Number : 815-485-6197
Fax Number :
Provider Business Practice Location Address
First Line : 210 N HAMMES AVE STE 204
Second Line :
City : JOLIET
State : IL
Zip : 60435-8139
Country : US
Telephone Number : 815-722-4384
Fax Number :
Authorized Official
Title or Position : CFO
Name : ROBERT TAYLOR
Credential :
Telephone Number : 815-320-7190
Provider Enumeration Date : 07/28/2020
Last Update Date : 07/28/2020

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