Triad Life Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MHL001189 Issued in NC

Legal business name

TRIAD LIFE SERVICES, LLC

Practice address

1135 Vaughn Rd
Burlington, NC 27217-2733

Phone

(336) 227-9028

NPI assigned

Mar 15, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Cassandra Phillipia Harvey

Title

Owner

Phone

(336) 350-0775

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Triad Life Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Triad Life Sevices, LLC.

  • Community/Behavioral Health Agency
  • Burlington, NC
  • NPI 1235377375
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268611200000",
    "number": "1154645513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 VAUGHN RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272172733",
            "telephone_number": "336-227-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 VAUGHN RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272172733",
            "telephone_number": "336-227-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD LIFE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-15",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "PHILLIPIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-350-0775",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL001189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235377375",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy M. Edwards, DDS, PA
• Guillermo Miguel Tremols, LCSW, LCAS
• Alexis S Trendowski, DDS
• Triad Health Care Services #2
• Triad Healthcare Services 1
• Triad Life Sevices, LLC.
• Triad Mobility & Supply LLC
• Triangle Community Intervention Services
• Triangle Community Interventions
• Triangle Home Care of the Triad

• All providers in Burlington, NC
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.