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Organization
TRIUMPH, LLC
Active
Organization
TRIUMPH, LLC
Active
Parent organization
TRIUMPH, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRIUMPH, LLC
Authorized official
TALESHA ROLLOCK (PROVIDER ENROLLMENT SPECIALIST)
(919) 256-0824
Entity
Organization
Contact information
Practice address
355 S MADISON BLVD, SUITE C2, ROXBORO, NC 27573-5485
(336) 597-2065
(336) 597-2116
Mailing address
3210 FAIRHILL DR, RALEIGH, NC 27612-3215
(919) 256-0824
(919) 256-0833
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
NC
103TC0700X
Clinical Psychologist
—
NC
1041C0700X
Clinical Social Worker
—
NC
Other
Enumeration date
03/12/2008
Last updated
02/24/2009
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