# TRINITY WILL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jireh Haven
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053495523
- **Authorized official:** MRS. SHIRLEY MELINDA WILLIAMS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (910) 525-5035

## Contact information

- **Practice address:** 140 FAULKNER LN, ROSEBORO, NC 28382-5415
- **Practice address phone:** (910) 525-5035
- **Practice address fax:** (910) 525-5065
- **Mailing address:** PO BOX 618, CLINTON, NC 28329-0618
- **Mailing address phone:** (910) 590-2971
- **Mailing address fax:** (910) 596-2971

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL082046 | NC | Yes |

## Other

- **Enumeration date:** 10/24/2006
- **Last updated:** 01/02/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6603564 | — | NC |