Basic Information
| Provider Information | |||||||||
| NPI: | 1699267153 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRUMPET BEHAVIORAL HEALTH, LLC | ||||||||
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| OtherOrganizationName: | TRUMPET BEHAVIORAL HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 390 UNION BLVD STE 300 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802286514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039898169 | ||||||||
| FaxNumber: | 3039844366 | ||||||||
| Practice Location | |||||||||
| Address1: | 1166 S GILBERT RD STE 106 | ||||||||
| Address2: | |||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852963461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808124789 | ||||||||
| FaxNumber: | 3039844366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2018 | ||||||||
| LastUpdateDate: | 05/11/2021 | ||||||||
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| AuthorizedOfficialLastName: | JOHNS | ||||||||
| AuthorizedOfficialFirstName: | KATHRYNNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF FINANCIAL SERVICES | ||||||||
| AuthorizedOfficialTelephone: | 7205800100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.