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Organization
TRIAD PLAY
Active
Organization
TRIAD PLAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMILAH USORO MED (FOUNDER)
(510) 485-4225
Entity
Organization
Contact information
Practice address
429 GILLESPIE ST, GREENSBORO, NC 27401-3628
(336) 303-1723
Mailing address
2941 BATTLEGROUND AVE # 39684, GREENSBORO, NC 27408-2705
(510) 485-4225
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
Other
Enumeration date
03/07/2025
Last updated
03/07/2025
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