| Triumph Llc | |
|
1683b Us 401 Hwy South Louisburg NC 27549-6829 | |
| (919) 496-5827 | |
| (919) 496-6452 |
| Full Name | Triumph Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1683b Us 401 Hwy South, Louisburg, North Carolina |
| Authorized Official Name and Position | Talesha M Rollock (PROVIDER ENROLLMENT SPECIALIST) |
| 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 1683b Us 401 Hwy South Louisburg NC 27549-6829 Ph: (919) 496-5827 |
| NPI Number | 1275679425 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 11/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275679425 | NPI | - | NPPES |
| 6005385 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
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