MEDICARE: TRANSITIONS BEHAVIORAL HEALTHCARE

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1295998607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSITIONS BEHAVIORAL HEALTHCARE

Provider Business Mailing Address
First Line	:	1310 E ARLINGTON BLVD
Second Line	:	SUITE A
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5868
Country	:	US
Telephone Number	:	252-321-6306
Fax Number	:	252-355-3689

Provider Business Practice Location Address
First Line	:	1310 E ARLINGTON BLVD
Second Line	:	SUITE A
City	:	GREENVILLE
State	:	NC
Zip	:	27858-5868
Country	:	US
Telephone Number	:	252-321-6306
Fax Number	:	252-355-3689

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PAUL ASHLEY BLEAU
Credential	:
Telephone Number	:	252-414-1347

Provider Enumeration Date	:	07/07/2008
Last Update Date	:	04/15/2009

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