Healthcare Provider Details

I. General information

NPI: 1588290506
Provider Name (Legal Business Name): TRINITY ADULT AND SENIOR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 07/15/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13818 HWY 55
BAYBORO NC
28515-9447
US

IV. Provider business mailing address

11560 NC 55 HWY STE 7
GRANTSBORO NC
28529-9447
US

V. Phone/Fax

Practice location:
  • Phone: 252-671-6437
  • Fax: 252-631-0340
Mailing address:
  • Phone: 252-242-0088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: RENITA KIRKMAN
Title or Position: OWNER
Credential:
Phone: 252-671-6437