MEDICARE: TRANSITIONAL COMMUNITY SUPPORT 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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1780327734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSITIONAL COMMUNITY SUPPORT SERVICES, LLC

Provider Business Mailing Address
First Line	:	8837 EMERALD DUNES CIR
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23832-2439
Country	:	US
Telephone Number	:	804-510-4922
Fax Number	:

Provider Business Practice Location Address
First Line	:	8837 EMERALD DUNES CIR
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23832-2439
Country	:	US
Telephone Number	:	804-510-4922
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JACQUELYN SMITH
Credential	:
Telephone Number	:	910-320-3213

Provider Enumeration Date	:	04/18/2022
Last Update Date	:	04/18/2022

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