Provider Demographics
NPI:1396243739
Name:TRUMPET BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:TRUMPET BEHAVIORAL HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SYSTEMS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIORENZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-989-8174
Mailing Address - Street 1:390 UNION BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-6514
Mailing Address - Country:US
Mailing Address - Phone:303-989-8169
Mailing Address - Fax:
Practice Address - Street 1:11698 HURON ST UNIT 106
Practice Address - Street 2:
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234
Practice Address - Country:US
Practice Address - Phone:720-381-0264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRUMPET BEHAVIORAL HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-31
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85850055Medicaid