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General NPI Number Information
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NPI Number | 1902070022
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Entity Type | Organization
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Legal Business Name | TRINITYDEALERS
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 109 K ST
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City | SPARKS
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State | NV
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Zip | 89431-3212
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Country | US
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Telephone | 775-313-3341
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Fax | 775-293-4113
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Provider Business Mailing Address
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Address Line | 109 K ST
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City | SPARKS
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State | NV
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Zip | 89431-3212
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Country | US
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Telephone | 775-313-3341
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Fax | 775-293-4113
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Authorized Official
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Title or Position | MANAGER
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Name | COURAGE OSAWE
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Credential |
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Telephone | 775-313-3341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1006160043
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License Number State | NV
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