Provider Demographics
NPI:1083981807
Name:TRIAD MOBILITY,INC
Entity Type:Organization
Organization Name:TRIAD MOBILITY,INC
Other - Org Name:TRIAD BEHAVIORAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:PRINCESS
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-235-8177
Mailing Address - Street 1:1025 HOMELAND AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-7003
Mailing Address - Country:US
Mailing Address - Phone:336-235-8177
Mailing Address - Fax:
Practice Address - Street 1:1025 HOMELAND AVE STE 5
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-7003
Practice Address - Country:US
Practice Address - Phone:336-235-8177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health