=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255466637
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRINITY PLUS HEALTHCARE SERVICES INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/23/2007
-----------------------------------------------------
Last Update Date | 09/19/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2500 WILSHIRE BLVD SUITE 922
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90057-4303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-487-9800
-----------------------------------------------------
Fax | 310-487-9801
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2500 WILSHIRE BLVD SUITE 922
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90057-4303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-487-9800
-----------------------------------------------------
Fax | 310-487-9801
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTIVE
-----------------------------------------------------
Name | MR. CHIKE REX ANYAOHA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 213-487-9800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0401X
-----------------------------------------------------
Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------