Healthcare Provider Details

I. General information

NPI: 1508134909
Provider Name (Legal Business Name): TRINBRES FAMILY HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2011
Last Update Date: 12/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11907 QUAIL RD.
HAMPTON GA
30228
US

IV. Provider business mailing address

11907 QUAIL RD
HAMPTON GA
30228-6292
US

V. Phone/Fax

Practice location:
  • Phone: 404-784-4349
  • Fax:
Mailing address:
  • Phone: 404-784-4349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberCN0028899410
License Number StateGA

VIII. Authorized Official

Name: MS. CHARLOTTE ANN COTTON
Title or Position: CNA/HOMEHEALTH AIDE
Credential: CERTIFIED NURSE AIDE
Phone: 404-784-4349