MEDICARE: TRIANGLE EMPOWERMENT CENTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QM0850X	Adult Mental Health Clinic/Center
3	261QM0855X	Adolescent and Children Mental Health Clinic/Center
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1285402651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIANGLE EMPOWERMENT CENTER

Provider Business Mailing Address
First Line	:	112 BROADWAY ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27701-2402
Country	:	US
Telephone Number	:	919-717-6922
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 BROADWAY ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27701-2402
Country	:	US
Telephone Number	:	919-717-6922
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TERRY MUNN
Credential	:
Telephone Number	:	919-717-6922

Provider Enumeration Date	:	12/15/2023
Last Update Date	:	12/15/2023

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Directions to “TRIANGLE EMPOWERMENT CENTER ” Practice Location

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