Provider Demographics
NPI:1225164387
Name:TRINITY INNOVATIVE PROGRAMMING SERVICES, INC.
Entity Type:Organization
Organization Name:TRINITY INNOVATIVE PROGRAMMING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DARIUS
Authorized Official - Middle Name:CHARELL
Authorized Official - Last Name:MONROE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:910-583-1890
Mailing Address - Street 1:1631 KARA CT
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-2052
Mailing Address - Country:US
Mailing Address - Phone:910-717-0504
Mailing Address - Fax:910-717-0536
Practice Address - Street 1:1631 KARA CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-2052
Practice Address - Country:US
Practice Address - Phone:910-717-0504
Practice Address - Fax:910-717-0536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC005569251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management