Healthcare Provider Details

I. General information

NPI: 1588097372
Provider Name (Legal Business Name): TRINITY THERAPEUTIC CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2013
Last Update Date: 08/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6196 OXON HILL RD SUITE 260
OXON HILL MD
20745-3100
US

IV. Provider business mailing address

6196 OXON HILL RD SUITE 260
OXON HILL MD
20745-3100
US

V. Phone/Fax

Practice location:
  • Phone: 301-485-1657
  • Fax: 301-485-1689
Mailing address:
  • Phone: 301-485-1657
  • Fax: 301-485-1689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. BELINDA FROST
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: PSYD
Phone: 301-485-1657