Healthcare Provider Details

I. General information

NPI: 1275427882
Provider Name (Legal Business Name): THE TRANSFORMATION CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2513 TWILIGHT RIDGE WAY
LAS CRUCES NM
88011-2756
US

IV. Provider business mailing address

206 SOUTHBRIDGE ST STE 1
AUBURN MA
01501-2680
US

V. Phone/Fax

Practice location:
  • Phone: 508-466-7117
  • Fax:
Mailing address:
  • Phone: 508-466-7117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BRENDA VEZINA-JODAITIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 508-466-7117