Trinity Support Services LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-041-839 Issued in NC

Legal business name

TRINITY SUPPORT SERVICES LLC

Practice address

1717 Gavin Drive
High Point, NC 27260-5506

Phone

(336) 889-6905

Fax

(336) 889-6905

NPI assigned

Dec 5, 2007

Last updated

Sep 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Suzanne Salaam Salaam

Title

Program Director

Phone

(336) 491-5423

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Trinity Restoration Center Other name

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1477736007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2532",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272162532",
            "telephone_number": "336-513-2204",
            "fax_number": "336-513-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 GAVIN DRIVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272605506",
            "telephone_number": "336-889-6905",
            "fax_number": "336-889-6905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "SALAAM",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "SALAAM",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "336-491-5423",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-041-839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MHL-041-839",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Restoration Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in High Point, NC
• Providers in High Point, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.