Provider Demographics
NPI:1811639594
Name:TRILOGY RECOVERY COMMUNITY
Entity type:Organization
Organization Name:TRILOGY RECOVERY COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLIVER
Authorized Official - Middle Name:A T
Authorized Official - Last Name:BIRCHWOOD-GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:509-876-4525
Mailing Address - Street 1:120 E BIRCH ST STE 14
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3054
Mailing Address - Country:US
Mailing Address - Phone:509-876-4525
Mailing Address - Fax:509-591-9911
Practice Address - Street 1:120 E BIRCH ST STE 14
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-3054
Practice Address - Country:US
Practice Address - Phone:509-876-4525
Practice Address - Fax:509-591-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health