Healthcare Provider Details

I. General information

NPI: 1538622899
Provider Name (Legal Business Name): TRANSITIONS RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2019
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2406 G ST
BEDFORD IN
47421-5120
US

IV. Provider business mailing address

2811 WASHINGTON AVE
BEDFORD IN
47421-5310
US

V. Phone/Fax

Practice location:
  • Phone: 812-675-0377
  • Fax:
Mailing address:
  • Phone: 812-675-0902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JERRY WAYNE FORD
Title or Position: OWNER
Credential:
Phone: 812-675-0902