Healthcare Provider Details

I. General information

NPI: 1689631046
Provider Name (Legal Business Name): TRANSITIONAL LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 09/02/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2052 PRINCETON RD
FAIRFIELD TOWNSHIP OH
45011-4746
US

IV. Provider business mailing address

1020 SYMMES RD
FAIRFIELD OH
45014-1844
US

V. Phone/Fax

Practice location:
  • Phone: 513-863-6383
  • Fax: 513-863-9882
Mailing address:
  • Phone: 513-645-4578
  • Fax: 513-883-1546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number519651
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberRF-02-1931
License Number StateOH

VIII. Authorized Official

Name: SCOTT GEHRING
Title or Position: CEO
Credential:
Phone: 513-896-8300