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General NPI Number Information
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NPI Number | 1700800455
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Entity Type | Organization
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Legal Business Name | TRINITY VISITING NURSE AND HOMECARE ASSOCIATION
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 12/21/2010
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Provider Practice Location Address
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Address Line | 4500 UTICA RIDGE ROAD
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City | BETTENDORF
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State | IA
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Zip | 52722
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Country | US
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Telephone | 563-742-4700
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Fax | 563-742-4705
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Provider Business Mailing Address
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Address Line | 106 19 AVENUE SUITE 101
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City | MOLINE
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State | IL
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Zip | 61265
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Country | US
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Telephone | 309-779-7600
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Fax | 309-779-7252
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. TODD J RICHARD
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Credential | PT
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Telephone | 309-779-7242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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