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General NPI Number Information
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NPI Number | 1255875787
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Entity Type | Organization
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Legal Business Name | TRINITY COMMUNITY DEVELOPMENT CORPORATION
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Dates
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Enumeration Date | 12/19/2016
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Last Update Date | 01/03/2017
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Provider Practice Location Address
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Address Line | 501 E MAIN ST C2
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City | TROTWOOD
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State | OH
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Zip | 45426-2947
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Country | US
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Telephone | 404-782-2988
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Fax |
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Provider Business Mailing Address
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Address Line | 501 E MAIN ST C2
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City | TROTWOOD
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State | OH
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Zip | 45426-2947
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Country | US
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Telephone | 404-782-2988
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LEILAND WOODS
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Credential |
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Telephone | 404-782-2988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management 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 | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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