| Organization Name: | TRIAD TELECARE, INC. |
| NPI Number: | 1790825354 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PEARLIE M. BULLOCK (ADMINISTRATOR) |
| Mailing Address: | 1324 Coltrane Mill Rd Randleman |
| State: | NC US |
| Postal Code: | 273178020 |
| Phone Number: | 3365746293 |
| Fax Number: | |
| NPI Enumeration Date: | 02/06/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 177F00000X |
| License Number: | HAL076008 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Lodging |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. |