Provider Demographics
NPI:1104075191
Name:TRISTAN'S QUEST, INC.
Entity type:Organization
Organization Name:TRISTAN'S QUEST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:336-501-0860
Mailing Address - Street 1:115 S WALNUT CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-2624
Mailing Address - Country:US
Mailing Address - Phone:336-547-7460
Mailing Address - Fax:336-292-6133
Practice Address - Street 1:115 S WALNUT CIR
Practice Address - Street 2:SUITE A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-2624
Practice Address - Country:US
Practice Address - Phone:336-547-7460
Practice Address - Fax:336-292-6133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health