Provider Demographics
NPI:1265126130
Name:CHIMNEY TRAIL COMPANY
Entity type:Organization
Organization Name:CHIMNEY TRAIL COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-632-7789
Mailing Address - Street 1:8459 SAND DOLLAR DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80528-8617
Mailing Address - Country:US
Mailing Address - Phone:720-930-5390
Mailing Address - Fax:
Practice Address - Street 1:8459 SAND DOLLAR DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80528-8617
Practice Address - Country:US
Practice Address - Phone:720-930-5390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty