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General NPI Number Information
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NPI Number | 1114274263
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Entity Type | Organization
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Legal Business Name | TRINITY SUPPORT SERVICES
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Dates
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Enumeration Date | 08/08/2012
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 3005 WILLIAMSON RD NW
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City | ROANOKE
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State | VA
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Zip | 24012-4313
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Country | US
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Telephone | 540-491-0566
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Fax | 276-632-0590
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Provider Business Mailing Address
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Address Line | 3005 WILLIAMSON RD NW
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City | ROANOKE
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State | VA
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Zip | 24012-4313
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Country | US
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Telephone | 540-491-0566
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Fax | 276-632-0590
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Authorized Official
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Title or Position | OWNER
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Name | MS. CARLA SUE YOPP
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Credential |
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Telephone | 276-224-7403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1753
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License Number State | VA
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