Organization
TRINITY III, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWEN FOX (PRESIDENT)
(704) 482-0901
Entity
Organization
Contact information
Practice address
716 WEST GRAHAM STREET, SHELBY, NC 28150
(704) 482-0901
Mailing address
PO BOX 477, SHELBY, NC 28150
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL023088
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603223
—
NC
Enumeration date
04/14/2009
Last updated
04/14/2009
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