Provider Demographics
NPI:1295200889
Name:TRELLIS BEHAVIOR AND LEARNING SOLUTIONS, LLC
Entity Type:Organization
Organization Name:TRELLIS BEHAVIOR AND LEARNING SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:SONMOR
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:334-790-7460
Mailing Address - Street 1:2153 YOUNG FARM PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3136
Mailing Address - Country:US
Mailing Address - Phone:334-790-7460
Mailing Address - Fax:877-789-4775
Practice Address - Street 1:4241 LOMAC ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2879
Practice Address - Country:US
Practice Address - Phone:334-790-7460
Practice Address - Fax:877-789-4775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-10
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health