Healthcare Provider Details

I. General information

NPI: 1306496492
Provider Name (Legal Business Name): TRINITY HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2019
Last Update Date: 09/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 ANDREW AVENUE
LAPORTE IN
46350
US

IV. Provider business mailing address

1200 ROOSEVELT PLACE UNIT A
VALPARAISO IN
46383-8427
US

V. Phone/Fax

Practice location:
  • Phone: 219-548-4663
  • Fax: 219-477-5920
Mailing address:
  • Phone: 219-548-4663
  • Fax: 219-477-5920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MELVYNE D CUETO
Title or Position: VP OF THERAPY OPERATIONS
Credential: PT
Phone: 219-548-4663