Healthcare Provider Details

I. General information

NPI: 1104209162
Provider Name (Legal Business Name): TRANSITION FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 08/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16000 PROVIDENCE DR STE. 100
SOUTHFIELD MI
48075
US

IV. Provider business mailing address

24000 MORTON ST
OAK PARK MI
48237-2185
US

V. Phone/Fax

Practice location:
  • Phone: 248-499-4312
  • Fax:
Mailing address:
  • Phone: 248-499-4312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: TAMIKA MARIE REEVES
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: LLPC
Phone: 248-499-4312