=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366779936
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRINITY ANGELS HEALTHCARE SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/03/2009
-----------------------------------------------------
Last Update Date | 11/08/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2306 GUTHRIE ROAD SUITE # 260-F
-----------------------------------------------------
City | GARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75043-5967
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-226-1600
-----------------------------------------------------
Fax | 214-309-9207
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2306 GUTHRIE ROAD SUITE # 260-F
-----------------------------------------------------
City | GARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75043-5967
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-226-1600
-----------------------------------------------------
Fax | 214-309-9207
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO/OWNER
-----------------------------------------------------
Name | MR. JOBI ABRAHAM
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 972-226-1600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3747A0650X
-----------------------------------------------------
Taxonomy Name | Attendant Care Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3747P1801X
-----------------------------------------------------
Taxonomy Name | Personal Care Attendant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------