Healthcare Provider Details

I. General information

NPI: 1609834191
Provider Name (Legal Business Name): TRINITY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/21/2021
Certification Date: 09/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18100 W OAK AVE
LOCKPORT IL
60441-6125
US

IV. Provider business mailing address

301 VETERANS PARKWAY
NEW LENOX IL
60451-2899
US

V. Phone/Fax

Practice location:
  • Phone: 815-723-4894
  • Fax: 815-485-5975
Mailing address:
  • Phone: 815-485-6197
  • Fax: 815-485-5975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateIL

VIII. Authorized Official

Name: BOB TAYLOR
Title or Position: CFO
Credential:
Phone: 815-320-7190