| Triumph Llc | |
|
60 Nc Highway 125 Roanoke Rapids NC 27870-6304 | |
| (252) 537-6619 | |
| (252) 537-6786 |
| Full Name | Triumph Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 60 Nc Highway 125, Roanoke Rapids, North Carolina |
| Authorized Official Name and Position | Talesha Sydney (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 60 Nc Highway 125 Roanoke Rapids NC 27870-6304 Ph: (252) 537-6619 |
| NPI Number | 1962548115 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 11/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962548115 | NPI | - | NPPES |
| 6005741 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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