Provider Demographics
NPI:1174973630
Name:TRINITY CONSUMER DIRECTED SERVICE LLC.
Entity type:Organization
Organization Name:TRINITY CONSUMER DIRECTED SERVICE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURE/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-367-5453
Mailing Address - Street 1:5223 DELMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1027
Mailing Address - Country:US
Mailing Address - Phone:314-367-5453
Mailing Address - Fax:314-361-7354
Practice Address - Street 1:5223 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1027
Practice Address - Country:US
Practice Address - Phone:314-367-5453
Practice Address - Fax:314-361-7354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty