Provider Demographics
NPI:1992472286
Name:HUMMINGBIRD BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:HUMMINGBIRD BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERALYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLERY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:970-779-0699
Mailing Address - Street 1:11813 ROAD 27.1
Mailing Address - Street 2:
Mailing Address - City:DOLORES
Mailing Address - State:CO
Mailing Address - Zip Code:81323-9247
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11813 ROAD 27.1
Practice Address - Street 2:
Practice Address - City:DOLORES
Practice Address - State:CO
Practice Address - Zip Code:81323-9247
Practice Address - Country:US
Practice Address - Phone:970-779-0699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty