MEDICARE: TRANSITIONAL COMMUNITY SUPPORT 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
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1588515803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSITIONAL COMMUNITY SUPPORT LLC

Provider Business Mailing Address
First Line	:	706 E DAVIS ST
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-5924
Country	:	US
Telephone Number	:	804-510-4922
Fax Number	:

Provider Business Practice Location Address
First Line	:	1319 CROSS LINK RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-4846
Country	:	US
Telephone Number	:	804-510-4922
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JACQUELINE HALE
Credential	:
Telephone Number	:	804-510-4922

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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