Healthcare Provider Details

I. General information

NPI: 1184102907
Provider Name (Legal Business Name): TRINITY FIRST HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2018
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 SOUTHERN OAK LOOP
MINNEOLA FL
34715-5705
US

IV. Provider business mailing address

1727 SOUTHERN OAK LOOP
MINNEOLA FL
34715-5705
US

V. Phone/Fax

Practice location:
  • Phone: 352-978-6233
  • Fax: 352-708-4497
Mailing address:
  • Phone: 352-978-6233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number StateFL

VIII. Authorized Official

Name: KATRINA DENISE BATTLE
Title or Position: CEO
Credential:
Phone: 352-978-6233