Provider Demographics
NPI:1700360583
Name:TRINITY CARE INC
Entity type:Organization
Organization Name:TRINITY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KEHINDE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUSOGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-714-9823
Mailing Address - Street 1:4004 GREENWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5560
Mailing Address - Country:US
Mailing Address - Phone:817-714-9823
Mailing Address - Fax:
Practice Address - Street 1:4004 GREENWOOD WAY
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5560
Practice Address - Country:US
Practice Address - Phone:817-714-9823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2023-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX261QM0850XMedicaid