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General NPI Number Information
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NPI Number | 1164557278
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Entity Type | Organization
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Legal Business Name | TRINITY HOUSE, INC.
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 1803 LOCHWOOD DR
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City | GREENSBORO
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State | NC
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Zip | 27406-8574
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Country | US
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Telephone | 336-965-1305
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 78054
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City | GREENSBORO
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State | NC
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Zip | 27427-8054
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Country | US
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Telephone | 336-965-1305
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. YOLANDE HARRISON
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Credential |
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Telephone | 336-965-1305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | MHL-041-805
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License Number State | NC
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