Provider Demographics
NPI:1972210623
Name:TRINITY'S ARMS LLC
Entity Type:Organization
Organization Name:TRINITY'S ARMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-751-3036
Mailing Address - Street 1:1042 OLD BOILING SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28152-0517
Mailing Address - Country:US
Mailing Address - Phone:203-751-3036
Mailing Address - Fax:
Practice Address - Street 1:229 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-4009
Practice Address - Country:US
Practice Address - Phone:203-751-3036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0000Medicaid