MEDICARE: TRIAGE BEHAVIORAL HEALTH SYSTEMS

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	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972688760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIAGE BEHAVIORAL HEALTH SYSTEMS

Provider Business Mailing Address
First Line	:	301 N MAIN ST
Second Line	:	SUITE 2500
City	:	WINSTON SALEM
State	:	NC
Zip	:	27101-3836
Country	:	US
Telephone Number	:	336-722-3104
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N MAIN ST
Second Line	:	SUITE 2500
City	:	WINSTON SALEM
State	:	NC
Zip	:	27101-3836
Country	:	US
Telephone Number	:	336-722-3104
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	PATRICK LIVINGSTON
Credential	:
Telephone Number	:	336-722-3104

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	08/22/2020

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