| Organization Name: | TRILLIUM CARE GROUP LLC |
| NPI Number: | 1477629640 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERESA C ORTIZ (CLINICAL DIRECTOR PSYCHOTHERAPIST) |
| Mailing Address: | 500 Elm Grove Rd Suite 100 Elm Grove |
| State: | WI US |
| Postal Code: | 53122 |
| Phone Number: | 2627822090 |
| Fax Number: | 2627822092 |
| NPI Enumeration Date: | 11/28/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 2564 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |