MEDICARE: TRANSITIONAL LIFE CASE MANAGEMENT

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	251B00000X	Case Management Agency		TX

General Provider Information

NPI Number	:	1326408980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSITIONAL LIFE CASE MANAGEMENT

Provider Business Mailing Address
First Line	:	2626 S LOOP W STE 650E
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-5628
Country	:	US
Telephone Number	:	409-877-2032
Fax Number	:	713-456-2381

Provider Business Practice Location Address
First Line	:	2626 S LOOP W STE 650E
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-5628
Country	:	US
Telephone Number	:	409-877-2032
Fax Number	:	713-456-2381

Authorized Official
Title or Position	:	OWNER
Name	:	DEMPSEY SPEARS
Credential	:	LPC-S
Telephone Number	:	409-877-2032

Provider Enumeration Date	:	02/25/2016
Last Update Date	:	02/25/2016

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Directions to “TRANSITIONAL LIFE CASE MANAGEMENT ” Practice Location

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