MEDICARE: TRIANGLE INDUSTRIES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283Q00000X	Psychiatric Hospital	H-11/2004 (2)	MI

General Provider Information

NPI Number	:	1033108832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIANGLE INDUSTRIES INC

Provider Business Mailing Address
First Line	:	15000 GRATIOT AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48205-1973
Country	:	US
Telephone Number	:	313-245-0600
Fax Number	:	313-372-8657

Provider Business Practice Location Address
First Line	:	15000 GRATIOT AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48205-1973
Country	:	US
Telephone Number	:	313-245-0600
Fax Number	:	313-372-8657

Authorized Official
Title or Position	:	HOSPITAL PRESIDENT
Name	:	MR. CHARLES JOSEPH POWELL
Credential	:
Telephone Number	:	313-245-0625

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	08/22/2020

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Directions to “TRIANGLE INDUSTRIES INC ” Practice Location

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