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General NPI Number Information
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NPI Number | 1922209121
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Entity Type | Organization
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Legal Business Name | TRILLIUM FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 4455 NE HWY 20
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City | CORVALLIS
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State | OR
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Zip | 97330-9695
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Country | US
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Telephone | 541-757-1852
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Fax | 503-205-0193
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Provider Business Mailing Address
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Address Line | 3415 SE POWELL BLVD
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City | PORTLAND
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State | OR
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Zip | 97202-3371
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Country | US
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Telephone | 503-205-4362
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Fax | 503-205-0193
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Authorized Official
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Title or Position | SR. BILLING MANAGER
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Name | SUZY VENZKE
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Credential |
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Telephone | 503-205-4362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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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 | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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