Provider Demographics
NPI:1902070022
Name:TRINITYDEALERS
Entity type:Organization
Organization Name:TRINITYDEALERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:COURAGE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSAWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-313-3341
Mailing Address - Street 1:109 K ST
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-3212
Mailing Address - Country:US
Mailing Address - Phone:775-313-3341
Mailing Address - Fax:775-293-4113
Practice Address - Street 1:109 K ST
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-3212
Practice Address - Country:US
Practice Address - Phone:775-313-3341
Practice Address - Fax:775-293-4113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1006160043101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty