Provider Demographics
NPI:1932913183
Name:TRIUNE COMMUNITY TREATMENT SERVICES
Entity type:Organization
Organization Name:TRIUNE COMMUNITY TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCDC III
Authorized Official - Phone:234-214-0258
Mailing Address - Street 1:4414 22ND ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1574
Mailing Address - Country:US
Mailing Address - Phone:234-214-0258
Mailing Address - Fax:234-214-0290
Practice Address - Street 1:4414 22ND ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1574
Practice Address - Country:US
Practice Address - Phone:234-214-0258
Practice Address - Fax:234-214-0290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health