Healthcare Provider Details

I. General information

NPI: 1518473826
Provider Name (Legal Business Name): TRIUSPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2017
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3090 S JAMAICA CT STE 102
AURORA CO
80014-2684
US

IV. Provider business mailing address

3090 S JAMAICA CT STE 102
AURORA CO
80014-2684
US

V. Phone/Fax

Practice location:
  • Phone: 720-577-9517
  • Fax:
Mailing address:
  • Phone: 720-577-9517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BARTHOLOMEW BAAH
Title or Position: CEO
Credential:
Phone: 720-577-9517