Basic Information
| Provider Information | |||||||||
| NPI: | 1336207802 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRANSITIONS MENTAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1586 PALOMA PL | ||||||||
| Address2: | |||||||||
| City: | ARROYO GRANDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934205176 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054733150 | ||||||||
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| Practice Location | |||||||||
| Address1: | 277 SOUTH ST STE Y | ||||||||
| Address2: | BOX 15408 | ||||||||
| City: | SAN LUIS OBISPO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934015039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055415144 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | DIAZ | ||||||||
| AuthorizedOfficialFirstName: | DENISSE | ||||||||
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| AuthorizedOfficialTitleorPosition: | RESOURCE SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 8055415144 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | X | Agencies | Case Management | 261QM0801X | X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.