Healthcare Provider Details

I. General information

NPI: 1861529471
Provider Name (Legal Business Name): TRIO HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date: 04/08/2014
Reactivation Date: 04/22/2014

III. Provider practice location address

4444 CORONA SUITE 205
CORPUS CHRISTI TX
78411-4325
US

IV. Provider business mailing address

4444 CORONA SUITE 205
CORPUS CHRISTI TX
78411-4325
US

V. Phone/Fax

Practice location:
  • Phone: 361-881-8787
  • Fax: 361-881-8815
Mailing address:
  • Phone: 361-881-8767
  • Fax: 361-881-8815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number014579
License Number StateTX

VIII. Authorized Official

Name: VAN PHAN VILLA
Title or Position: ADMINISTRATOR
Credential:
Phone: 361-881-8787