Healthcare Provider Details

I. General information

NPI: 1932953650
Provider Name (Legal Business Name): COMMUNITY TRANSITION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2024
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 N EVERGREEN RD STE 102
SPOKANE VALLEY WA
99216-0993
US

IV. Provider business mailing address

420 N EVERGREEN RD STE 102
SPOKANE VALLEY WA
99216-0993
US

V. Phone/Fax

Practice location:
  • Phone: 509-867-3930
  • Fax: 509-867-3931
Mailing address:
  • Phone: 509-867-3930
  • Fax: 509-867-3931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MERRILLINA L MOSBY
Title or Position: OWNER
Credential:
Phone: 509-951-7769