Trinity Connections Consultants, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

031012988 Issued in GA

Legal business name

TRINITY CONNECTIONS CONSULTANTS, LLC

Practice address

659 Wilmont Dr
Jonesboro, GA 30238-4834

Phone

(678) 887-6644

Fax

(678) 284-1699

NPI assigned

Nov 11, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Hayward White Jr.

Title

Ceo

Phone

(678) 887-6644

Specialties & licenses 2

Addresses

Other names 1

• TRINITY PLACE Doing business as

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289433600000",
    "number": "1871894568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2955",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302818938",
            "telephone_number": "678-887-6644",
            "fax_number": "678-284-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 WILMONT DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302384834",
            "telephone_number": "678-887-6644",
            "fax_number": "678-284-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY CONNECTIONS CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-11",
        "last_updated": "2010-11-11",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "HAYWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-887-6644",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "031012988",
            "primary": true
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "GA",
            "license": "031012988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRINITY PLACE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.