Provider Demographics
NPI:1740744283
Name:TRI PLEX INDUSTRIES CORP
Entity type:Organization
Organization Name:TRI PLEX INDUSTRIES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-406-3586
Mailing Address - Street 1:8116 S TRYON ST STE 11
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-4300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-854-8514
Practice Address - Street 1:9635 SOUTHERN PINE BLVD STE 154
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-5564
Practice Address - Country:US
Practice Address - Phone:980-406-3586
Practice Address - Fax:888-854-8514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities