Organization
TRINITY PLACE RISING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMIKA HICKS (ADMINISTRATOR)
(704) 301-2372
Entity
Organization
Contact information
Practice address
1252 N LIBERTY ST, WINSTON SALEM, NC 27101-1631
(704) 293-1901
Mailing address
16948 COMMONS CREEK DR, CHARLOTTE, NC 28277-2077
(704) 293-1901
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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