Organization
TRINITY VISITING NURSE AND HOMECARE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD J RICHARD PT (EXECUTIVE DIRECTOR)
(309) 779-7242
Entity
Organization
Contact information
Practice address
106 19TH AVE, SUITE 101, MOLINE, IL 61265-3700
(309) 779-7600
(309) 779-7252
Mailing address
106 19TH AVE, SUITE 101, MOLINE, IL 61265-3700
(309) 779-7600
(309) 779-7252
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1002237
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0908434
—
IA
01
—
96359
WELLMARK IA
—
01
—
96360
WELLMARK
—
01
—
9691
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/26/2006
Last updated
12/21/2010
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