NPIMap

Organization Active NPI

Trinity Village, Inc

  • Assisted Living Facility
  • Pine Bluff, AR
National Provider Identifier
1831596659
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
089 Issued in AR
Legal business name
TRINITY VILLAGE, INC
Practice address
6400 Trinity Dr
Pine Bluff, AR 71603-7802
Phone
(870) 879-3113
Fax
(870) 879-2246
NPI assigned
Nov 21, 2014
Organization subpart
Yes
Parent organization
TRINITY VILLAGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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

Authorized official

Name
Mrs. Donna Stone
Title
Executive Director
Phone
(870) 879-3113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 089 AR Primary

Addresses

Primary practice location

6400 Trinity Dr
Pine Bluff, AR 71603-7802

Mailing address

6400 Trinity Dr
Pine Bluff, AR 71603-7802
Phone (870) 879-3113

Other identifiers 1

IdentifierTypeStateIssuer
202271794MedicaidAR

Other names 1

  • Trinity Village Assisted Living Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Trinity Village Inc3 organizations share this tax ID, including this one
Part of
Trinity Village Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416528000000",
    "number": "1831596659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 TRINITY DR",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037802",
            "telephone_number": "870-879-3113",
            "fax_number": "870-879-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 TRINITY DR",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716037802",
            "telephone_number": "870-879-3113",
            "fax_number": "870-879-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY VILLAGE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRINITY VILLAGE",
        "enumeration_date": "2014-11-21",
        "last_updated": "2014-11-21",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "870-879-3113",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AR",
            "license": "089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202271794",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Village Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; 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.