Organization
TRINITY DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYSTI MEDINA (CEO)
(559) 321-1870
Entity
Organization
Contact information
Practice address
1568 N MILLBROOK AVE, FRESNO, CA 93703-4149
(559) 412-8996
(559) 840-1714
Mailing address
1568 N MILLBROOK AVE, FRESNO, CA 93703-4149
(559) 412-8996
(559) 840-1714
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
107202360
CA
251C00000X
Developmentally Disabled Services Day Training Agency
107202360
CA
251S00000X
Community/Behavioral Health Agency
107202360
CA
251V00000X
Voluntary or Charitable Agency
107202360
CA
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
11/12/2010
Last updated
03/15/2011
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