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NPI Code Detail

MEDICARE: TRINITY INDEPENDENT LIVING SERVICES LLC

MEDICARE: TRINITY INDEPENDENT LIVING SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency10327LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053436444
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRINITY INDEPENDENT LIVING SERVICES LLC
Provider Business Mailing Address
First Line : 2113 VICKERS DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70815-2281
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3009 MONTERREY DR STE C
Second Line :
City : BATON ROUGE
State : LA
Zip : 70814-4022
Country : US
Telephone Number : 225-928-0205
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MARY ALCEE
Credential :
Telephone Number : 225-272-8418
Provider Enumeration Date : 03/21/2007
Last Update Date : 08/22/2020

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Directions to “TRINITY INDEPENDENT LIVING SERVICES LLC ” Practice Location

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