Triad Behavioral Resources Pc

LBN: Triad Behavioral Resources Pc
Triad Behavioral Resources Pc is an health care organization with primary practice located at 12 N 5Th Ave , Wilmington NC 28401-4537. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Triad Behavioral Resources Pc can be contacted via phone (910) 765-1003, or through Bolton, David via phone (910) 765-1003.

Contact Information

Primary practice address
12 N 5Th Ave Wilmington NC 28401-4537
Fax: (910) 765-1004
Website:
Authorized official contact:
Name: Bolton, David

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MHL041686 North Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1336292556
LBN Legal business name Triad Behavioral Resources Pc
DBA Doing business as
Authorized official Bolton, David
Entity Organization
Organization subpart 1 No
Enumeration date Jan 19th, 2007
Last updated Sep 28th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336292556 NPPES
North Carolina MEDICAID 6005083
North Carolina Other 017U3

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