Healthcare Provider Details

I. General information

NPI: 1790873149
Provider Name (Legal Business Name): TRINITY HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6729 N WILLOW AVE STE103
FRESNO CA
93710-5952
US

IV. Provider business mailing address

PO BOX 532020
LIVONIA MI
48153-2020
US

V. Phone/Fax

Practice location:
  • Phone: 559-450-5112
  • Fax: 559-450-5694
Mailing address:
  • Phone: 877-827-0788
  • Fax: 734-343-6451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number040000174
License Number StateCA

VIII. Authorized Official

Name: MARCUS BOWENS
Title or Position: CFO
Credential:
Phone: 770-283-4006