Healthcare Provider Details

I. General information

NPI: 1790656072
Provider Name (Legal Business Name): TRILOGY YOUTH AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 AYRSLEY TOWN BLVD STE 202
CHARLOTTE NC
28273-4068
US

IV. Provider business mailing address

2015 AYRSLEY TOWN BLVD STE 202
CHARLOTTE NC
28273-4068
US

V. Phone/Fax

Practice location:
  • Phone: 704-766-9000
  • Fax: 704-216-9000
Mailing address:
  • Phone: 704-766-9000
  • Fax: 704-216-9000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. RAHMANA LATISA MOTT
Title or Position: CEO
Credential:
Phone: 704-766-9000