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General NPI Number Information
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NPI Number | 1093649154
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Entity Type | Organization
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Legal Business Name | TRANSFORM CENTRAL INC.
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 1353 HONEYSUCKLE RD APT 1
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City | DOTHAN
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State | AL
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Zip | 36305-1940
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Country | US
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Telephone | 334-796-4506
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Fax |
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Provider Business Mailing Address
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Address Line | 1353 HONEYSUCKLE RD APT 1
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City | DOTHAN
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State | AL
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Zip | 36305-1940
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Country | US
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Telephone | 334-796-4506
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Fax |
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Authorized Official
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Title or Position | MINISTER/EX. DIRECTOR
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Name | MR. JASON JOHNSON
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Credential | B.A. CRSS FBSS
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Telephone | 334-796-4506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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