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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
BRENDA FRAZIER (PROVIDER ENROLLMENT SPECIALIST)
(919) 256-0824
Entity
Organization
Contact information
Practice address
2209 CENTURY DR, SUITE 101, RALEIGH, NC 27612-3941
(919) 786-4944
(919) 786-4945
Mailing address
3210 FAIRHILL DR, RALEIGH, NC 27612-3215
(919) 256-0824
(919) 256-0833
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MLH-092-668
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8302184
—
NC
05
—
8302184Q
—
NC
Enumeration date
10/24/2007
Last updated
03/11/2008
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