Provider Demographics
NPI:1306038831
Name:TRINITY HOSPICE OF MINNESOTA, LLC
Entity type:Organization
Organization Name:TRINITY HOSPICE OF MINNESOTA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:A/R MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASSCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-306-4520
Mailing Address - Street 1:14180 DALLAS PKWY
Mailing Address - Street 2:SUITE 800
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-4341
Mailing Address - Country:US
Mailing Address - Phone:214-306-4520
Mailing Address - Fax:214-432-9220
Practice Address - Street 1:1270 NORTHLAND DR
Practice Address - Street 2:SUITE 155
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120-1156
Practice Address - Country:US
Practice Address - Phone:651-994-6740
Practice Address - Fax:651-994-4326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based