| Triumph Llc | |
|
119 W Depot St Mocksville NC 27028-2327 | |
| (336) 751-5636 | |
| (336) 751-5696 |
| Full Name | Triumph Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 119 W Depot St, Mocksville, North Carolina |
| Authorized Official Name and Position | Paul Caldwell (CEO) |
| Authorized Official Contact | 9194672433 |
| 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 119 W Depot St Mocksville NC 27028-2327 Ph: (336) 751-5636 |
| NPI Number | 1063568095 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 07/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063568095 | NPI | - | NPPES |
| 8300784V | Medicaid | NC | |
| 8300784H | Medicaid | NC | |
| 8300784G | Medicaid | NC | |
| 8300784 | Medicaid | NC | |
| 8300784B | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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