Organization
TRINITY HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH L FABUGAIS P.T. (OWNER / PRESIDENT)
(574) 223-4663
Entity
Organization
Contact information
Practice address
114 E 10TH ST, ROCHESTER, IN 46975-1747
(574) 223-4663
(574) 223-1663
Mailing address
114 E 10TH ST, ROCHESTER, IN 46975-1747
(574) 223-4663
(574) 223-1663
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15Q7607001
VALPARAISO, IN BRANCH MEDICARE #
IN
05
—
200926460A
—
IN
Enumeration date
05/14/2008
Last updated
10/04/2010
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