Organization
TRAIL HEAD SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM CLINKENBEARD (OWNER/MANAGER)
(970) 391-6838
Entity
Organization
Contact information
Practice address
2591 ELDORADO SPRINGS DR, LOVELAND, CO 80538-5321
(970) 391-6838
Mailing address
2591 ELDORADO SPRINGS DR, LOVELAND, CO 80538-5321
(970) 391-6838
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77279263
—
CO
Enumeration date
02/08/2016
Last updated
10/11/2016
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