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General NPI Number Information
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NPI Number | 1124291851
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Entity Type | Organization
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Legal Business Name | TRIANGLE RESOLUTIONS, LLC
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 09/04/2009
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Provider Practice Location Address
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Address Line | 10037 WATER WORKS LN
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City | RIVERVIEW
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State | FL
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Zip | 33578-5304
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Country | US
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Telephone | 813-714-6107
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Fax | 813-217-8174
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Provider Business Mailing Address
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Address Line | 10037 WATER WORKS LN
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City | RIVERVIEW
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State | FL
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Zip | 33578-5304
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Country | US
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Telephone | 813-714-6107
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Fax | 813-217-8174
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Authorized Official
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Title or Position | CEO
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Name | MR. DAMON WESELY DYE
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Credential | LMHC, NCGC II
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Telephone | 813-714-6107
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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 | MH 9382
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License Number State | FL
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