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General NPI Number Information
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NPI Number | 1720853336
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Entity Type | Organization
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Legal Business Name | TRINITY WAY ASSISTED LIVING FACILITY LLC
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Dates
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Enumeration Date | 11/24/2023
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 7015 COLLEGE PARK DR
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City | EASTVALE
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State | CA
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Zip | 92880-3231
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Country | US
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Telephone | 323-806-2313
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Fax |
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Provider Business Mailing Address
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Address Line | 7015 COLLEGE PARK DR
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City | EASTVALE
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State | CA
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Zip | 92880-3231
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Country | US
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Telephone | 323-806-2313
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Fax |
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | KIMBERLY LIGON
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Credential | PSYD
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Telephone | 323-806-2313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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