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Organization
TRIUMPH LLC
Active
Organization
TRIUMPH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL CALDWELL (CEO)
(919) 467-2433
Entity
Organization
Contact information
Practice address
119 W DEPOT ST, MOCKSVILLE, NC 27028-2327
(336) 751-5636
(336) 751-5696
Mailing address
3210 FAIRHILL DR, RALEIGH, NC 27612-3215
(919) 256-0824
(919) 256-0833
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300784
—
NC
05
—
8300784B
—
NC
05
—
8300784G
—
NC
05
—
8300784H
—
NC
05
—
8300784V
—
NC
Enumeration date
01/25/2007
Last updated
07/22/2010
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