Provider Demographics
NPI:1427629724
Name:TRINITY LIFE SUPPORT COMMUNITY SERVICE DISTRICT
Entity type:Organization
Organization Name:TRINITY LIFE SUPPORT COMMUNITY SERVICE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARAMEDIC/FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:RATLIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-623-2500
Mailing Address - Street 1:PO BOX 2907
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96093-2907
Mailing Address - Country:US
Mailing Address - Phone:530-623-2500
Mailing Address - Fax:530-623-2614
Practice Address - Street 1:610 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:CA
Practice Address - Zip Code:96093-2907
Practice Address - Country:US
Practice Address - Phone:530-623-2500
Practice Address - Fax:530-623-2614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance