Provider Demographics
NPI:1255112884
Name:TRINITY COMPASSIONATE CARE COMPANION SERVICES, LLC
Entity type:Organization
Organization Name:TRINITY COMPASSIONATE CARE COMPANION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:SOLOMON-WARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-869-0246
Mailing Address - Street 1:320 NE JAY ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-7127
Mailing Address - Country:US
Mailing Address - Phone:850-869-0246
Mailing Address - Fax:
Practice Address - Street 1:313 SW PINCKNEY ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-2453
Practice Address - Country:US
Practice Address - Phone:850-869-0246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health