| Triumph Llc | |
|
3708 Mayfair St South Square 2 Durham NC 27707-6226 | |
| (919) 683-1800 | |
| (919) 490-5893 |
| Full Name | Triumph Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3708 Mayfair St, Durham, North Carolina |
| Authorized Official Name and Position | Harold E Jones (MEMBER MGR./OWNER) |
| Authorized Official Contact | 9192560824 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Triumph Llc 3210 Fairhill Dr Raleigh NC 27612-3215 Ph: (919) 256-0824 | Triumph Llc 3708 Mayfair St South Square 2 Durham NC 27707-6226 Ph: (919) 683-1800 |
| NPI Number | 1619024635 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 08/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619024635 | NPI | - | NPPES |
| 8301754 | Medicaid | NC | |
| 8301754G | Medicaid | NC | |
| 8301754V | Medicaid | NC | |
| 8301754H | Medicaid | NC | |
| 8301754B | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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