Healthcare Provider Details

I. General information

NPI: 1427229772
Provider Name (Legal Business Name): TRINITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 03/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40425 PEQUOT DR
BROWERVILLE MN
56438-4602
US

IV. Provider business mailing address

40425 PEQUOT DR
BROWERVILLE MN
56438-4602
US

V. Phone/Fax

Practice location:
  • Phone: 218-894-2937
  • Fax: 218-894-2937
Mailing address:
  • Phone: 218-894-2937
  • Fax: 218-894-2937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberL0629766
License Number StateMN

VIII. Authorized Official

Name: PATRICIA MOCK HODGE
Title or Position: OWNER
Credential: LPN
Phone: 218-894-2937