Provider Demographics
NPI:1366224768
Name:TRIUMPH OVER TRAUMA
Entity type:Organization
Organization Name:TRIUMPH OVER TRAUMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JONETHA
Authorized Official - Middle Name:AASIMAH
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:216-466-3675
Mailing Address - Street 1:9225 LINCOLN DR APT F10
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-1155
Mailing Address - Country:US
Mailing Address - Phone:216-466-3675
Mailing Address - Fax:
Practice Address - Street 1:9225 LINCOLN DR APT F10
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-1155
Practice Address - Country:US
Practice Address - Phone:216-466-3675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health