Provider Demographics
NPI:1457626491
Name:A TRINITY CONNECTIONS
Entity Type:Organization
Organization Name:A TRINITY CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BLAKE
Authorized Official - Middle Name:LANAIR
Authorized Official - Last Name:DANNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-675-1980
Mailing Address - Street 1:914 E GARRISON BLVD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-4571
Mailing Address - Country:US
Mailing Address - Phone:704-675-1580
Mailing Address - Fax:704-864-1580
Practice Address - Street 1:914 E GARRISON BLVD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-4571
Practice Address - Country:US
Practice Address - Phone:704-675-1890
Practice Address - Fax:704-864-1019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty