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General NPI Number Information
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NPI Number | 1386717379
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Entity Type | Organization
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Legal Business Name | TRINITY - ADULT DAY HEALTH CARE PROGRAM
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17261 BAISLEY BLVD
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City | JAMAICA
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State | NY
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Zip | 11434-2614
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Country | US
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Telephone | 718-525-2997
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Fax | 718-525-7843
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Provider Business Mailing Address
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Address Line | 50 SHEFFIELD AVE
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City | BROOKLYN
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State | NY
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Zip | 11207-2420
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Country | US
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Telephone | 718-345-2273
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Fax | 718-485-9236
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. STEVEN REAGAN
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Credential |
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Telephone | 718-345-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 7001364N
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License Number State | NY
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