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Organization

TRILLIUM FAMILY SOLUTIONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KATHY K TRUBISKY MED, EDS, LPC-S (PRESIDENT/CEO)
(330) 454-7066
Entity
Organization

Contact information

Practice address
624 MARKET AVE N, CANTON, OH 44702-1017
(330) 454-7066
(330) 454-7066
Mailing address
624 MARKET AVE N, CANTON, OH 44702-1017
(330) 454-7066
(330) 454-7066

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
10023
OH
261Q00000X
Clinic/Center
Primary
10023, 12456, 12457
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10023
MACSIS UPI
OH
05
2098340
OH
Enumeration date
05/16/2012
Last updated
05/16/2012
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