Triumph Residential, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

TRIUMPH RESIDENTIAL, LLC

Practice address

3001 Churchland Blvd
Chesapeake, VA 23321-5603

Phone

(757) 761-3921

NPI assigned

Dec 23, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Vernon Lamont Tillage Jr.

Title

Ceo

Phone

(757) 761-3921

Specialties & licenses 1

Addresses

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Triumph Residential Services, LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • South Chesterfield, VA
  • NPI 1376933051
  NPPES parent name

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1760021695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 OLD FARM RD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237032623",
            "telephone_number": "757-761-3921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 CHURCHLAND BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215603",
            "telephone_number": "757-761-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIUMPH RESIDENTIAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "TILLAGE",
        "authorized_official_first_name": "VERNON",
        "authorized_official_middle_name": "LAMONT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-761-3921",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah M Tribus, BSN, RN, IBCLC
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• Salvador Bernard Trinidad, M.D.
• Trinity Hospice 1, LLC
• Marissa Trohaugh
• Mary O Trosien, FNPC
• Tashana Latrice Trotter
• Brianna Troxel, LAT, ATC, MSAT
• Deanna Troy-Billups, RBT

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.