Provider Demographics
NPI:1164674941
Name:TRINITY THERAPY SERVICES, INC.
Entity Type:Organization
Organization Name:TRINITY THERAPY SERVICES, INC.
Other - Org Name:THERAPY ONE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ITFS, COTA/L DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L, ITFS,
Authorized Official - Phone:252-341-7193
Mailing Address - Street 1:2656 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-9158
Mailing Address - Country:US
Mailing Address - Phone:252-341-7193
Mailing Address - Fax:252-756-6331
Practice Address - Street 1:2656 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-9158
Practice Address - Country:US
Practice Address - Phone:252-341-7193
Practice Address - Fax:252-756-6331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-11
Last Update Date:2008-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3850224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7301566Medicaid