# TRIAD PLAY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568260131
- **Authorized official:** KAMILAH USORO MED (FOUNDER)
- **Authorized official phone:** (510) 485-4225

## Contact information

- **Practice address:** 429 GILLESPIE ST, GREENSBORO, NC 27401-3628
- **Practice address phone:** (336) 303-1723
- **Mailing address:** 2941 BATTLEGROUND AVE \# 39684, GREENSBORO, NC 27408-2705
- **Mailing address phone:** (510) 485-4225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/07/2025
- **Last updated:** 03/07/2025