Provider Demographics
NPI:1598005241
Name:TRILOGY GUARDIAN SERVICES, LLC
Entity type:Organization
Organization Name:TRILOGY GUARDIAN SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:KYLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-702-8267
Mailing Address - Street 1:8207 HUDSON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2805
Mailing Address - Country:US
Mailing Address - Phone:806-702-8267
Mailing Address - Fax:
Practice Address - Street 1:8207 HUDSON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2805
Practice Address - Country:US
Practice Address - Phone:806-702-8267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-17
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG-13-0406251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management