Healthcare Provider Details

I. General information

NPI: 1942364062
Provider Name (Legal Business Name): THE TRANSITION HOUSE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 5TH ST
SAINT CLOUD FL
34769
US

IV. Provider business mailing address

3800 5TH ST
SAINT CLOUD FL
34769-2024
US

V. Phone/Fax

Practice location:
  • Phone: 407-892-5700
  • Fax:
Mailing address:
  • Phone: 407-892-5700
  • Fax: 407-891-0091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number0749AD891306
License Number StateFL

VIII. Authorized Official

Name: MELISSA LUCAS
Title or Position: CEO
Credential: MBA, PHR, SHRM-CP
Phone: 407-346-2849