Provider Demographics
NPI:1235711672
Name:TRIVIUM LIFE SERVICES
Entity type:Organization
Organization Name:TRIVIUM LIFE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF RCM
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:FRANCESCA
Authorized Official - Last Name:SCHALLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMHP
Authorized Official - Phone:712-355-8480
Mailing Address - Street 1:4201 RIVERS EDGE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-2515
Mailing Address - Country:US
Mailing Address - Phone:712-355-8480
Mailing Address - Fax:712-256-6502
Practice Address - Street 1:835 GORDON DR
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-1829
Practice Address - Country:US
Practice Address - Phone:712-522-3346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRIVIUM LIFE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-26
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health