TRIAD OUTREACH LLC NPI 1154911162

NPI Information

NPI: 1154911162
Provider Name: TRIAD OUTREACH LLC
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address: 4533 VERNON CIR
KERNERSVILLE, NC
ZIP 27284
Phone: (336) 615-6738

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NPI Details

TRIAD OUTREACH LLC is a residential treatment facility, intellectual and/or developmental disabilities in Kernersville, NC. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. TRIAD OUTREACH LLC NPI is 1154911162. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4533 VERNON CIR
KERNERSVILLE, NC
ZIP 27284-136
Phone: (336) 615-6738

The provider's authorized official is Kevin Walton .
The authorized official title is Owner and has the following contact phone number (336) 615-6738.

The enumeration date for this NPI number is 1/23/2021 and was last updated on 1/23/2021.

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	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	1041C0700X	Social Worker	Clinical	No
3	207QA0000X	Family Medicine	Adolescent Medicine	No
4	207QA0505X	Family Medicine	Adult Medicine	No
5	251S00000X	Community/Behavioral Health		No
6	261QD1600X	Clinic/Center	Developmental Disabilities	No
7	261QH0100X	Clinic/Center	Health Service	No
8	261QM0850X	Clinic/Center	Adult Mental Health	No
9	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
10	3245S0500X	Substance Abuse Rehabilitation Facility	Substance Abuse Treatment, Children	No
11	385HR2060X	Respite Care	Respite Care, Intellectual and/or Developmental Disabilities	No
12	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities		Yes

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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