Provider Demographics
NPI:1801663828
Name:TRIANGLE HEALTH LLC
Entity type:Organization
Organization Name:TRIANGLE HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOOMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-762-8833
Mailing Address - Street 1:PO BOX 65
Mailing Address - Street 2:
Mailing Address - City:EFLAND
Mailing Address - State:NC
Mailing Address - Zip Code:27243-0065
Mailing Address - Country:US
Mailing Address - Phone:508-762-8833
Mailing Address - Fax:
Practice Address - Street 1:948 BURNING MAPLE LN
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-9958
Practice Address - Country:US
Practice Address - Phone:508-762-8833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No251E00000XAgenciesHome Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities