Provider Demographics
NPI:1184960775
Name:TRINITY SERVICES LLC
Entity type:Organization
Organization Name:TRINITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LAVON
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-895-6270
Mailing Address - Street 1:415 HOOD ST
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-3831
Mailing Address - Country:US
Mailing Address - Phone:910-895-6270
Mailing Address - Fax:888-622-5121
Practice Address - Street 1:415 HOOD ST
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-3831
Practice Address - Country:US
Practice Address - Phone:910-895-6270
Practice Address - Fax:888-622-5121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC077073251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1346486412Medicaid
NC6008028Medicaid
NC5915266Medicaid
NC8302679Medicaid