MEDICARE: TRANSITIONAL SERVICES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility	2539T0004JN08	IN

General Provider Information

NPI Number	:	1013966605
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSITIONAL SERVICES, INC

Provider Business Mailing Address
First Line	:	2009 MAXWELL AVE
Second Line	:	P.O. BOX 4795
City	:	EVANSVILLE
State	:	IN
Zip	:	47711-4359
Country	:	US
Telephone Number	:	812-433-3333
Fax Number	:	812-433-3322

Provider Business Practice Location Address
First Line	:	11 WASHINGTON ST
Second Line	:
City	:	BROWNSBURG
State	:	IN
Zip	:	46112-1344
Country	:	US
Telephone Number	:	317-247-9835
Fax Number	:	317-247-9835

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. KENNETH S GOLDSTEIN
Credential	:	PH.D.
Telephone Number	:	812-433-3333

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	08/22/2020

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