Organization
TRILLIUM FAMILY SOLUTIONS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY K TRUBISKY MED EDS LPC-S (CHIEF EXECUTIVE OFFICER)
(330) 454-7066
Entity
Organization
Contact information
Practice address
624 MARKET AVE N, CANTON, OH 44702-1017
(330) 454-7066
(330) 454-9427
Mailing address
624 MARKET AVE N, CANTON, OH 44702-1017
(330) 454-7066
(330) 454-9427
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
—
—
261Q00000X
Clinic/Center
10023
OH
261Q00000X
Clinic/Center
524
OH
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
524
OH
261QM0850X
Adult Mental Health Clinic/Center
524
OH
261QM0855X
Adolescent and Children Mental Health Clinic/Center
524
OH
3336C0002X
Clinic Pharmacy
021542450
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10023
MACSIS UPI
OH
05
—
2098340
—
OH
Enumeration date
04/25/2006
Last updated
03/06/2012
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