MEDICARE: TRANSITIONAL LEARNING CENTER AT GALVESTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3104A0625X	Assisted Living Facility (Mental Illness)
2	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)
3	310400000X	Assisted Living Facility	134987	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	150157	OTHER	TX	TEXAS HEALTH & HUMAN SERVICES ASSISTED LIVING FACILITY LICENSE
2	148770	OTHER	TX	TEXAS HEALTH & HUMAN SERVICES ASSISTED LIVING FACILITY LICENSE

General Provider Information

NPI Number	:	1053743856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSITIONAL LEARNING CENTER AT GALVESTON

Provider Business Mailing Address
First Line	:	1528 POSTOFFICE STREET
Second Line	:
City	:	GALVESTON
State	:	TX
Zip	:	77550-4833
Country	:	US
Telephone Number	:	409-797-1468
Fax Number	:

Provider Business Practice Location Address
First Line	:	6444 CENTRAL CITY BLVD
Second Line	:
City	:	GALVESTON
State	:	TX
Zip	:	77551-2058
Country	:	US
Telephone Number	:	409-741-3266
Fax Number	:

Authorized Official
Title or Position	:	CONTRACT MANAGER
Name	:	JAMES ANDERSON
Credential	:
Telephone Number	:	409-797-1468

Provider Enumeration Date	:	08/02/2013
Last Update Date	:	12/09/2019

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Directions to “TRANSITIONAL LEARNING CENTER AT GALVESTON ” Practice Location

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