NPI Information

  • NPI: 1053495523
  • Provider Name: TRINITY WILL GROUP
  • Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
  • Entity Type: Organization
  • Doing Business As: JIREH HAVEN
  • Address: 140 FAULKNER LN
    ROSEBORO, NC
    ZIP 28382
  • Phone: (910) 525-5035

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NPI Details

TRINITY WILL GROUP is a residential treatment facility emotionally disturbed children in Roseboro, NC. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. TRINITY WILL GROUP NPI is 1053495523. The provider is registered as an organization entity type.
The provider Is Doing Business As Jireh Haven.

The provider's business location address is:

140 FAULKNER LN
ROSEBORO, NC
ZIP 28382-415
Phone: (910) 525-5035
Fax: (910) 525-5065

The provider's authorized official is Shirley Melinda Williams .
The authorized official title is Executive Director and has the following contact phone number (910) 525-5035.

The enumeration date for this NPI number is 10/24/2006 and was last updated on 1/2/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenMHL082046NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16603564MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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