Healthcare Provider Details

I. General information

NPI: 1366347353
Provider Name (Legal Business Name): TRIAD FAMILY AND CHILDRENS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W FRIENDLY AVE STE 100A
GREENSBORO NC
27401-6130
US

IV. Provider business mailing address

500 W FRIENDLY AVE STE 100A
GREENSBORO NC
27401-6130
US

V. Phone/Fax

Practice location:
  • Phone: 336-938-0077
  • Fax: 336-232-1516
Mailing address:
  • Phone: 336-938-0077
  • Fax: 336-232-1516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROBERTA DENISE BRINKLEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 336-986-9787