Healthcare Provider Details

I. General information

NPI: 1437867314
Provider Name (Legal Business Name): TRINITY AT HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S INDUSTRIAL BLVD STE 260
EULESS TX
76040-5073
US

IV. Provider business mailing address

610 S INDUSTRIAL BLVD STE 260
EULESS TX
76040-5073
US

V. Phone/Fax

Practice location:
  • Phone: 817-939-3789
  • Fax: 817-786-7500
Mailing address:
  • Phone: 817-939-3789
  • Fax: 817-786-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: ANDREA ROACH
Title or Position: ADMINISTRATOR
Credential:
Phone: 817-939-3789