Provider Demographics
NPI:1033574462
Name:TRANSITIONS MENTAL HEALTH ASSOCIATION
Entity Type:Organization
Organization Name:TRANSITIONS MENTAL HEALTH ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY ASSURANCE
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KEVER
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MA
Authorized Official - Phone:805-540-6532
Mailing Address - Street 1:PO BOX 15408
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93406-5408
Mailing Address - Country:US
Mailing Address - Phone:805-540-6500
Mailing Address - Fax:805-540-6501
Practice Address - Street 1:1998 SANTA BARBARA AVE
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4427
Practice Address - Country:US
Practice Address - Phone:805-548-2644
Practice Address - Fax:805-540-6501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 261QC1500X
CA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health