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General NPI Number Information
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NPI Number | 1255112884
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Entity Type | Organization
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Legal Business Name | TRINITY COMPASSIONATE CARE COMPANION SERVICES, LLC
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Dates
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Enumeration Date | 10/10/2023
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 313 SW PINCKNEY ST
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City | MADISON
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State | FL
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Zip | 32340-2453
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Country | US
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Telephone | 850-869-0246
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Fax |
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Provider Business Mailing Address
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Address Line | 320 NE JAY ST
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City | MADISON
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State | FL
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Zip | 32340-7127
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Country | US
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Telephone | 850-869-0246
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARY ELLEN SOLOMON-WARE
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Credential |
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Telephone | 850-869-0246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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