Basic Information
| Provider Information | |||||||||
| NPI: | 1992023634 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | QUALITY BEHAVIORAL OUTCOMES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5729 SONOMA DR | ||||||||
| Address2: | SUITE F | ||||||||
| City: | PLEASANTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945667782 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9254849990 | ||||||||
| FaxNumber: | 9254849992 | ||||||||
| Practice Location | |||||||||
| Address1: | 5729 SONOMA DR | ||||||||
| Address2: | SUITE K | ||||||||
| City: | PLEASANTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945667782 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9254622281 | ||||||||
| FaxNumber: | 9254620439 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2010 | ||||||||
| LastUpdateDate: | 05/05/2010 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGING DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9254849990 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | TRUMPET BEHAVIORAL HEALTH | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.