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General NPI Number Information
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NPI Number | 1700241429
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Entity Type | Organization
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Legal Business Name | TRINITY MENTAL HEALTH SERVICE, LLC
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 9100 ARBORETUM PKWY SUITE 265
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-3499
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Country | US
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Telephone | 804-986-8383
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Fax | 804-272-3654
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Provider Business Mailing Address
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Address Line | 9100 ARBORETUM PKWY SUITE 265
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-3499
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Country | US
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Telephone | 804-986-8383
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Fax | 804-272-3654
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | LOUIS DUCHIN
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Credential | MD
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Telephone | 804-986-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101055519
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License Number State | VA
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