Healthcare Provider Details

I. General information

NPI: 1851023329
Provider Name (Legal Business Name): TRANSITIONS THRU LIFE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2022
Last Update Date: 02/01/2023
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 MAIN ST
BENWOOD WV
26031-1105
US

IV. Provider business mailing address

445 MAIN ST
BENWOOD WV
26031-1105
US

V. Phone/Fax

Practice location:
  • Phone: 304-232-4411
  • Fax:
Mailing address:
  • Phone: 304-559-3199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CC (CELISE) RENEE ROXBY
Title or Position: CEO
Credential: BSS, BSP
Phone: 304-559-3199