Provider Demographics
NPI:1720302847
Name:TRI-HEALTH GROUP
Entity Type:Organization
Organization Name:TRI-HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-531-0104
Mailing Address - Street 1:4822 ALBEMARLE RD
Mailing Address - Street 2:LL130
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6668
Mailing Address - Country:US
Mailing Address - Phone:704-531-0104
Mailing Address - Fax:704-531-0104
Practice Address - Street 1:4822 ALBEMARLE RD
Practice Address - Street 2:LL130
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6668
Practice Address - Country:US
Practice Address - Phone:704-531-0104
Practice Address - Fax:704-531-0104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7609101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty