Healthcare Provider Details

I. General information

NPI: 1164475521
Provider Name (Legal Business Name): TRANSITIONAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1917 S LIBERTY DR
BLOOMINGTON IN
47403-5146
US

IV. Provider business mailing address

PO BOX 4795
EVANSVILLE IN
47724-0795
US

V. Phone/Fax

Practice location:
  • Phone: 812-433-3333
  • Fax: 812-433-3322
Mailing address:
  • Phone: 812-433-3333
  • Fax: 812-433-3322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: KENNETH S GOLDSTEIN
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 812-433-3333