Provider Demographics
NPI:1548991458
Name:TRUSTAR HEALTHCARE LLC
Entity type:Organization
Organization Name:TRUSTAR HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RASHIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SOYEBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-707-0524
Mailing Address - Street 1:2701 W 84TH AVE STE 155
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-3846
Mailing Address - Country:US
Mailing Address - Phone:773-707-0524
Mailing Address - Fax:
Practice Address - Street 1:2701 W 84TH AVE STE 155
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3846
Practice Address - Country:US
Practice Address - Phone:773-707-0524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-21
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services