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General NPI Number Information
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NPI Number | 1679087753
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Entity Type | Organization
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Legal Business Name | TRINITY HEALTH CARE SERVICES
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Dates
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Enumeration Date | 11/27/2017
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Last Update Date | 12/27/2017
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Provider Practice Location Address
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Address Line | 1033 CORPORATE SQUARE DR STE 125
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City | SAINT LOUIS
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State | MO
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Zip | 63132-2928
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Country | US
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Telephone | 314-548-9209
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Fax |
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Provider Business Mailing Address
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Address Line | 11 DAWNRIDGE DR
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City | HAZELWOOD
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State | MO
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Zip | 63042-2674
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Country | US
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Telephone | 314-548-9209
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JANE MWANGI
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Credential |
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Telephone | 314-548-9209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 22915338
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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