Healthcare Provider Details

I. General information

NPI: 1760348882
Provider Name (Legal Business Name): TRINITY COMMUNITY LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 SW SHELBY AVE
MADISON FL
32340-2334
US

IV. Provider business mailing address

308 SW SHELBY AVE
MADISON FL
32340-2334
US

V. Phone/Fax

Practice location:
  • Phone: 850-253-5700
  • Fax:
Mailing address:
  • Phone: 850-212-3491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MRS. GLORIA MOBLEY-WHITE
Title or Position: OWNER
Credential:
Phone: 850-212-3491