Healthcare Provider Details

I. General information

NPI: 1962606848
Provider Name (Legal Business Name): TRINITY CENTRAL HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 CENTRAL AVE STE 511
HOT SPRINGS AR
71901-5310
US

IV. Provider business mailing address

415 ROGERS AVE
FORT SMITH AR
72901-1903
US

V. Phone/Fax

Practice location:
  • Phone: 501-321-0708
  • Fax: 501-321-9567
Mailing address:
  • Phone: 479-783-4672
  • Fax: 479-783-2217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number4312
License Number StateAR

VIII. Authorized Official

Name: MICHAEL S MORTON
Title or Position: MEMBER
Credential:
Phone: 479-783-4672