Traces Trinity, LLC
Organization Active NPI Adult Companion · Dillard, GA
NPI 1043766348 · NPPES record last updated Aug 28, 2016
Key facts
- NPI
- 1043766348
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Companion 372600000X
- Legal business name
- TRACES TRINITY, LLC
- Practice address
- 92 Bettys Creek Rd
Dillard, GA 30537-2257 - Phone
- (706) 746-6571
- Fax
- (706) 746-5643
- NPI assigned
- Aug 28, 2016
- Organization subpart
- No
Authorized official
- Name
- Ms. Carlie Suzanne Pennington
- Title
- Sole MB
- Phone
- (706) 746-6571
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion |
372600000X | Yes |
Addresses
Primary practice location
92 Bettys Creek Rd
Dillard, GA 30537-2257
Mailing address
382 Bridge Creek Road
Tiger, GA 30576
Phone (706) 782-6208
Other names
- Traces of Tiger Adult Day Care
Other providers in Dillard, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.