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General NPI Number Information
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NPI Number | 1356990501
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Entity Type | Organization
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Legal Business Name | TRANSFORMCARE, INC
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 7811 MONTROSE RD STE 410
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City | POTOMAC
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State | MD
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Zip | 20854-3347
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Country | US
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Telephone | 240-264-5789
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 W MARSHALL AVE STE 428
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City | LONGVIEW
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State | TX
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Zip | 75604-5077
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Country | US
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Telephone | 903-806-6674
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KEVIN A DORRANCE
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Credential | MD
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Telephone | 240-264-5789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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