Provider Demographics
NPI:1083753792
Name:TRILLIUM BEHAVIORAL LLC
Entity Type:Organization
Organization Name:TRILLIUM BEHAVIORAL LLC
Other - Org Name:SILVERLAKE BEHAVIORAL ASSOCIATES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:281-412-6863
Mailing Address - Street 1:2225 CR 90
Mailing Address - Street 2:STE 215
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581
Mailing Address - Country:US
Mailing Address - Phone:281-412-6863
Mailing Address - Fax:281-412-6863
Practice Address - Street 1:2225 CR 90
Practice Address - Street 2:STE 215
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581
Practice Address - Country:US
Practice Address - Phone:281-412-6863
Practice Address - Fax:281-412-6863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty