MEDICARE: TRINITY OAKS SKILLED CARE 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1225991268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY OAKS SKILLED CARE LLC

Provider Business Mailing Address
First Line	:	17722 ROUGH RIVER CT
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-8265
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	17722 ROUGH RIVER CT
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-8265
Country	:	US
Telephone Number	:	347-804-9172
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DR. OSMUND UGOCHUKWU AGBO
Credential	:	MD
Telephone Number	:	347-804-9172

Provider Enumeration Date	:	12/05/2025
Last Update Date	:	04/06/2026

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