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General NPI Number Information
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NPI Number | 1437837002
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Entity Type | Organization
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Legal Business Name | TRANSITION RECOVER AND PROSPER LLC.
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 122 N CEDAR AVE
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City | HENRICO
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State | VA
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Zip | 23075-1429
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Country | US
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Telephone | 804-503-8454
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Fax |
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Provider Business Mailing Address
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Address Line | 122 N CEDAR AVE
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City | HENRICO
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State | VA
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Zip | 23075-1429
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Country | US
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Telephone | 804-503-8454
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TYREE DEANA TALLEY
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Credential | QMHP A/C CSAC
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Telephone | 804-503-8454
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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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