Healthcare Provider Details

I. General information

NPI: 1205759602
Provider Name (Legal Business Name): TRI-CITYSERVICE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 DIGGS DR STE G
RALEIGH NC
27603-2785
US

IV. Provider business mailing address

1411 DIGGS DR STE G
RALEIGH NC
27603-2785
US

V. Phone/Fax

Practice location:
  • Phone: 919-890-5770
  • Fax: 919-832-0514
Mailing address:
  • Phone: 919-890-5770
  • Fax: 919-832-0415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101200000X
TaxonomyDrama Therapist
License Number
License Number State

VIII. Authorized Official

Name: YEHIA HUSSEIN
Title or Position: OWNER
Credential: HUSSEIN
Phone: 919-890-5770