Trinity Mission of Diboll, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

114018 Issued in TX

Legal business name

TRINITY MISSION OF DIBOLL, LLC

Doing business as

Trinity Mission Health & Rehab of Diboll

Practice address

900 S Temple Dr
Diboll, TX 75941-2725

Phone

(936) 829-5501

Fax

(936) 829-5503

NPI assigned

May 11, 2006

Last updated

Jul 24, 2014By the provider in NPPES

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

Christopher J Murphy

Title

President

Phone

(901) 937-7994

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Trinity Mission Health & Rehab of Diboll Doing business as

Locations

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1902856685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2723 SUMMER OAKS DR",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342858",
            "telephone_number": "901-937-7994",
            "fax_number": "901-937-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S TEMPLE DR",
            "city": "DIBOLL",
            "state": "TX",
            "postal_code": "759412725",
            "telephone_number": "936-829-5501",
            "fax_number": "936-829-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY MISSION OF DIBOLL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COVENANT DOVE, LLC",
        "enumeration_date": "2006-05-11",
        "last_updated": "2014-07-24",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-937-7994"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "114018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001001923",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Mission Health & Rehab of Diboll",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carlos Alberto Solorzano, CSFA
• Eula Sparks, LMSW
• Perlita Gicaro Tarongoy, PT
• Marilyn Thompson
• Katlyn Townsend
• Trinity Nursing and Rehabilitation of Diboll, LP
• Lacy Jae Wade

• Skilled Nursing Facility in Diboll, TX
• Providers in Diboll, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.