MEDICARE: HOLY TRINITY HOME HEALTH SERVICES INC

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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1205068772
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLY TRINITY HOME HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	8051 INDEPENDENCE DR
Second Line	:	STE C
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-3825
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8051 INDEPENDENCE DR
Second Line	:	STE C
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-3825
Country	:	US
Telephone Number	:	248-247-5338
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ALVIN M PEDROCHE
Credential	:
Telephone Number	:	248-247-5338

Provider Enumeration Date	:	08/18/2009
Last Update Date	:	08/18/2009

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