Trinity Mission Health & Rehab of Holly, LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

29 Issued in ID

Legal business name

TRINITY MISSION HEALTH & REHAB OF HOLLY, LP

Practice address

2105 12TH Ave Rd
Nampa, ID 83686-6312

Phone

(208) 467-5721

Fax

(208) 467-2748

NPI assigned

May 12, 2006

Organization subpart

Yes

Parent organization

COVENANT DOVE, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Judy Ullery

Title

President

Phone

(901) 937-7994

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1477503076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866312",
            "telephone_number": "208-467-5721",
            "fax_number": "208-467-2748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866312",
            "telephone_number": "208-467-5721",
            "fax_number": "208-467-2748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY MISSION HEALTH & REHAB OF HOLLY, LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COVENANT DOVE, LLC",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "ULLERY",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-937-7994",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ID",
            "license": "29",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A227401",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Treasure Valley Hospice, LLC
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• McKynna Treinen
• Vivian Nguyen Trinh, PHARMD
• Trinity Mission Health & Rehab of Midland, LP
• Lisa Dorothy Triolo, MS OTR/L
• Michael Anthony Triolo, RPH
• Tristan Galloway DDS PLLC
• Holly Tristan, FNTP

• Skilled Nursing Facility in Nampa, ID
• Providers in Nampa, ID by specialty
• Skilled Nursing Facility in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.