MEDICARE: TRINITY MEMORY 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1427861640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY MEMORY CARE LLC

Provider Business Mailing Address
First Line	:	17901 HUNTING BOW CIR STE 102
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33558-5394
Country	:	US
Telephone Number	:	727-744-3407
Fax Number	:

Provider Business Practice Location Address
First Line	:	8582 OLD COUNTY ROAD 54
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653
Country	:	US
Telephone Number	:	727-744-3407
Fax Number	:	727-744-3407

Authorized Official
Title or Position	:	MANAGER
Name	:	ERIC MOORE
Credential	:
Telephone Number	:	727-744-3407

Provider Enumeration Date	:	01/30/2025
Last Update Date	:	01/30/2025

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