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General NPI Number Information
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NPI Number | 1649695818
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Entity Type | Organization
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Legal Business Name | TRINITY VISITING NURSE AND HOME CARE LLC
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 10/24/2018
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Provider Practice Location Address
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Address Line | 4226 AVENIDA COCHISE STE 5
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-5818
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Country | US
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Telephone | 520-458-1536
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Fax | 520-458-4245
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Provider Business Mailing Address
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Address Line | 4226 AVENIDA COCHISE STE 5
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City | SIERRA VISTA
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State | AZ
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Zip | 85635-5818
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Country | US
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Telephone | 520-458-1536
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Fax | 520-458-4245
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CARINNA WILMOT
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Credential | RN, BSN, MSHCA
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Telephone | 520-458-1536
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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 | HHA6232
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License Number State | AZ
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