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General NPI Number Information
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NPI Number | 1164143640
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Entity Type | Organization
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Legal Business Name | LIFE IN TRANSITION LLC
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Dates
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Enumeration Date | 09/05/2022
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Last Update Date | 09/05/2022
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Provider Practice Location Address
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Address Line | 760 PENN ST
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City | MEDFORD
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State | OR
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Zip | 97501-4590
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Country | US
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Telephone | 541-591-6076
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1787
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City | MEDFORD
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State | OR
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Zip | 97501-0261
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Country | US
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Telephone | 541-500-8655
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Fax | 800-433-1396
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Authorized Official
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Title or Position | OWNER
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Name | AURA REICHERT
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Credential | LPCA
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Telephone | 541-591-6076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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