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Organization
TRIUMPH LLC
Active
Organization
TRIUMPH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TALESHA SYDNEY (PROVIDER ENROLLMENT SPECIALIST)
(919) 256-0824
Entity
Organization
Contact information
Practice address
309 WYCHE ST, HENDERSON, NC 27536-4246
(252) 431-0072
(252) 438-6364
Mailing address
3210 FAIRHILL DR, RALEIGH, NC 27612-3215
(919) 256-0824
(919) 256-0833
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301849
—
NC
05
—
8301849B
—
NC
05
—
8301849G
—
NC
05
—
8301849H
—
NC
05
—
8301849V
—
NC
Enumeration date
01/22/2007
Last updated
08/03/2010
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