Healthcare Provider Details

I. General information

NPI: 1245805704
Provider Name (Legal Business Name): TOUCH OF TRINITI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8748 MICMAC CT
POLK CITY FL
33868-6025
US

IV. Provider business mailing address

8748 MICMAC CT
POLK CITY FL
33868-6025
US

V. Phone/Fax

Practice location:
  • Phone: 863-412-1658
  • Fax:
Mailing address:
  • Phone: 863-412-1658
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CHASSIDEE TURNER
Title or Position: OWNER
Credential:
Phone: 863-412-1658