Provider Demographics
NPI:1083599278
Name:THE TRIUMPH COLLECTIVE
Entity type:Organization
Organization Name:THE TRIUMPH COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TENORIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-217-3765
Mailing Address - Street 1:2350 E MAYFIELD RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2703
Mailing Address - Country:US
Mailing Address - Phone:817-217-3765
Mailing Address - Fax:
Practice Address - Street 1:2350 E MAYFIELD RD BLDG B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2703
Practice Address - Country:US
Practice Address - Phone:817-217-3765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities