Healthcare Provider Details

I. General information

NPI: 1154316057
Provider Name (Legal Business Name): TRINITY TRANSITION ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 08/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8410 ROOSEVELT BLVD
PHILADELPHIA PA
19152-2012
US

IV. Provider business mailing address

8410 ROOSEVELT BLVD
PHILADELPHIA PA
19152-2012
US

V. Phone/Fax

Practice location:
  • Phone: 215-708-1200
  • Fax: 215-708-2967
Mailing address:
  • Phone: 215-708-1200
  • Fax: 215-708-2967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number128002
License Number StatePA

VIII. Authorized Official

Name: MISS BARBARA SORRENTINO
Title or Position: COO
Credential:
Phone: 215-708-1200