Healthcare Provider Details

I. General information

NPI: 1124786793
Provider Name (Legal Business Name): TRINITY FAMILY AND BEHAVIORAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16961 HORTON CT
DUMFRIES VA
22025-1987
US

IV. Provider business mailing address

16701 MELFORD BLVD STE 400
BOWIE MD
20715-4411
US

V. Phone/Fax

Practice location:
  • Phone: 240-705-4527
  • Fax:
Mailing address:
  • Phone: 240-705-4527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: FRANCISCA NKEM OKWUKOGU
Title or Position: OWNER
Credential: DNP, APRN, CRNP-PMH
Phone: 240-510-3281