Provider Demographics
NPI:1770318172
Name:TRIUMPHANT SUPPORT SERVICES INCORPORATED
Entity type:Organization
Organization Name:TRIUMPHANT SUPPORT SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DODSON
Authorized Official - Suffix:
Authorized Official - Credentials:CDCA, PRS
Authorized Official - Phone:216-303-5892
Mailing Address - Street 1:2490 LEE BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1269
Mailing Address - Country:US
Mailing Address - Phone:216-457-1873
Mailing Address - Fax:
Practice Address - Street 1:2490 LEE BLVD STE 230
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1269
Practice Address - Country:US
Practice Address - Phone:216-457-1873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management