Provider Demographics
NPI:1962876359
Name:TRIANGLE HEALTHY SENIORS
Entity type:Organization
Organization Name:TRIANGLE HEALTHY SENIORS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:H
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-544-6848
Mailing Address - Street 1:5007 SOUTHPARK DR
Mailing Address - Street 2:SUITE 200-H
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7739
Mailing Address - Country:US
Mailing Address - Phone:919-544-6848
Mailing Address - Fax:
Practice Address - Street 1:5007 SOUTHPARK DR
Practice Address - Street 2:SUITE 200-H
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7739
Practice Address - Country:US
Practice Address - Phone:919-544-6848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3766253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care