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NPI Code Detail

MEDICARE: TRANSFORMATIONS HEALTH SERVICES LLC

MEDICARE: TRANSFORMATIONS HEALTH SERVICES LLC
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1336753284
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRANSFORMATIONS HEALTH SERVICES LLC
Provider Business Mailing Address
First Line : 2023 CONNONADE DR
Second Line :
City : WAXHAW
State : NC
Zip : 28173-0109
Country : US
Telephone Number : 704-277-1750
Fax Number :
Provider Business Practice Location Address
First Line : 3650 MUDDY CREEK RD STE 100
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-2058
Country : US
Telephone Number : 513-347-0375
Fax Number :
Authorized Official
Title or Position : OWNER
Name : OMAR ELLISON
Credential :
Telephone Number : 704-277-1750
Provider Enumeration Date : 09/08/2020
Last Update Date : 04/16/2024

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