Provider Demographics
NPI:1417230442
Name:TRELLIS SERVICES INC.
Entity Type:Organization
Organization Name:TRELLIS SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-785-3845
Mailing Address - Street 1:164 LAKE FRONT DR
Mailing Address - Street 2:
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21030-2215
Mailing Address - Country:US
Mailing Address - Phone:410-785-3845
Mailing Address - Fax:410-785-3880
Practice Address - Street 1:164 LAKE FRONT DR
Practice Address - Street 2:
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21030-2215
Practice Address - Country:US
Practice Address - Phone:410-785-3845
Practice Address - Fax:410-785-3880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06731225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty