Healthcare Provider Details

I. General information

NPI: 1396662862
Provider Name (Legal Business Name): TRANSITION ASSISTED LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 MICHIGAN AVE
GLADSTONE MI
49837-1929
US

IV. Provider business mailing address

128 MICHIGAN AVE
GLADSTONE MI
49837-1929
US

V. Phone/Fax

Practice location:
  • Phone: 906-420-8900
  • Fax: 906-420-8901
Mailing address:
  • Phone: 906-420-8900
  • Fax: 906-420-8901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL HAYES-JACKSON
Title or Position: PRESIDENT & ADMINISTRATOR
Credential:
Phone: 310-990-8509