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General NPI Number Information
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NPI Number | 1316223993
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Entity Type | Organization
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Legal Business Name | TRG HEALTH CARE SYSTEMS LLC
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Dates
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Enumeration Date | 10/27/2011
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 708 N BROAD ST
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City | EDENTON
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State | NC
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Zip | 27932-1405
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Country | US
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Telephone | 919-556-4440
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1207
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City | WAKE FOREST
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State | NC
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Zip | 27588-1207
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Country | US
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Telephone | 919-556-4440
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EULANDA ELLIOTT
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Credential |
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Telephone | 919-925-3604
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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 |
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License Number State |
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