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NPI Code Detail

MEDICARE: TRELLIS BEHAVIOR AND LEARNING SOLUTIONS, LLC

MEDICARE: TRELLIS BEHAVIOR AND LEARNING SOLUTIONS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1295200889
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRELLIS BEHAVIOR AND LEARNING SOLUTIONS, LLC
Provider Business Mailing Address
First Line : 2153 YOUNG FARM PL
Second Line :
City : MONTGOMERY
State : AL
Zip : 36106-3136
Country : US
Telephone Number : 334-790-7460
Fax Number : 877-789-4775
Provider Business Practice Location Address
First Line : 4241 LOMAC ST
Second Line :
City : MONTGOMERY
State : AL
Zip : 36106-2879
Country : US
Telephone Number : 334-790-7460
Fax Number : 877-789-4775
Authorized Official
Title or Position : OWNER
Name : MRS. JENNIFER SONMOR UNDERWOOD
Credential : BCBA
Telephone Number : 334-790-7460
Provider Enumeration Date : 10/10/2018
Last Update Date : 01/13/2022

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Directions to “TRELLIS BEHAVIOR AND LEARNING SOLUTIONS, LLC ” Practice Location

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