Provider Demographics
NPI:1366909665
Name:TRINITY CARE ASSOCIATE
Entity type:Organization
Organization Name:TRINITY CARE ASSOCIATE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEAN MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:TCHAZOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-455-0756
Mailing Address - Street 1:100 MERRIMACK ST STE 205
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-1707
Mailing Address - Country:US
Mailing Address - Phone:978-455-0756
Mailing Address - Fax:978-455-0770
Practice Address - Street 1:100 MERRIMACK ST STE 201
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-1707
Practice Address - Country:US
Practice Address - Phone:774-420-1054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY CARE ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-23
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health