Provider Demographics
NPI:1003677022
Name:ADD TRANSITION AGENCY LLC
Entity Type:Organization
Organization Name:ADD TRANSITION AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WHEATON
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:720-771-1953
Mailing Address - Street 1:9070 SEDALIA ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-9156
Mailing Address - Country:US
Mailing Address - Phone:720-771-1953
Mailing Address - Fax:
Practice Address - Street 1:9070 SEDALIA ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-9156
Practice Address - Country:US
Practice Address - Phone:720-771-1953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management