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General NPI Number Information
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NPI Number | 1891605085
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Entity Type | Organization
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Legal Business Name | TREELINE PASS
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Dates
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Enumeration Date | 09/09/2026
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Last Update Date | 09/09/2026
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Provider Practice Location Address
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Address Line | 209 W HAMPDEN AVE
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City | ENGLEWOOD
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State | CO
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Zip | 80110-2401
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Country | US
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Telephone | 720-201-9812
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Fax |
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Provider Business Mailing Address
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Address Line | 209 W HAMPDEN AVE
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City | ENGLEWOOD
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State | CO
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Zip | 80110-2401
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Country | US
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Telephone | 720-201-9812
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | GABRIEL KOROLUK
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Credential |
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Telephone | 412-414-6304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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