Organization
TRINITY III INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GWENDOLYN FOX (PRESIDENT)
(704) 482-0901
Entity
Organization
Contact information
Practice address
214 NORTH MORGAN STREET, SHELBY, NC 28150
(704) 482-0901
(704) 482-2081
Mailing address
214 N MORGAN ST, SHELBY, NC 28150-4431
(704) 482-0901
(704) 482-2081
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-023-043
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-023-088
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-023-097
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603222
—
NC
05
—
6603223
—
NC
05
—
6603999
—
NC
Enumeration date
12/21/2006
Last updated
08/22/2020
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