Basic Information
| Provider Information | |||||||||
| NPI: | 1902455298 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRUMPET BEHAVIORAL HEALTH, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 390 UNION BLVD STE 300 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802286514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3039898169 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2902 GINNALA DR STE 1 | ||||||||
| Address2: | |||||||||
| City: | LOVELAND | ||||||||
| State: | CO | ||||||||
| PostalCode: | 805387818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703779401 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2019 | ||||||||
| LastUpdateDate: | 09/09/2019 | ||||||||
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| AuthorizedOfficialLastName: | JOHNS | ||||||||
| AuthorizedOfficialFirstName: | KATHRYNNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 3039898169 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | N | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.