Provider Demographics
NPI:1356401350
Name:TRIUMPH CENTER, INC.
Entity type:Organization
Organization Name:TRIUMPH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:781-942-9277
Mailing Address - Street 1:36 WOBURN ST
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:MA
Mailing Address - Zip Code:01867-2903
Mailing Address - Country:US
Mailing Address - Phone:781-942-9277
Mailing Address - Fax:781-944-6535
Practice Address - Street 1:36 WOBURN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2903
Practice Address - Country:US
Practice Address - Phone:781-942-9277
Practice Address - Fax:781-944-6535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAW10471103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty