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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 MONIQUE ROLLOCK (ASST. MANAGER/PROVIDER ENROLLMENT)
(919) 256-0824
Entity
Organization
Contact information
Practice address
104 KING CIRCLE, DANBURY, NC 27016-7634
(336) 593-8900
(336) 593-8973
Mailing address
3210 FAIRHILL DRIVE, RALEIGH, NC 27612-3220
(919) 256-0824
(919) 256-0833
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/09/2008
Last updated
07/09/2008
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