| Triumph, Llc | |
|
2209 Century Dr Suite 101 Raleigh NC 27612-3941 | |
| (919) 786-4944 | |
| (919) 786-4945 |
| Full Name | Triumph, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2209 Century Dr, Raleigh, North Carolina |
| Authorized Official Name and Position | Brenda Frazier (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 2209 Century Dr Suite 101 Raleigh NC 27612-3941 Ph: (919) 786-4944 |
| NPI Number | 1811176076 |
|---|---|
| Provider Enumeration Date | 10/24/2007 |
| Last Update Date | 03/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811176076 | NPI | - | NPPES |
| 8302184Q | Medicaid | NC | |
| 8302184 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MLH-092-668 (North Carolina) | Primary |
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