Provider Demographics
NPI:1689421034
Name:TRI THERAPY
Entity type:Organization
Organization Name:TRI THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DENIS
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:KELSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:480-773-8386
Mailing Address - Street 1:804 N 19TH AVE STE 2A
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6929
Mailing Address - Country:US
Mailing Address - Phone:406-404-1009
Mailing Address - Fax:406-404-1780
Practice Address - Street 1:804 N 19TH AVE STE 2A
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6929
Practice Address - Country:US
Practice Address - Phone:406-404-1009
Practice Address - Fax:406-404-1780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty