Provider Demographics
NPI:1083382774
Name:THE TRANSITION HOUSE, INC.
Entity Type:Organization
Organization Name:THE TRANSITION HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, PHR, SHRM-CP
Authorized Official - Phone:407-892-5700
Mailing Address - Street 1:3113-3115 INNOVATION DR
Mailing Address - Street 2:
Mailing Address - City:ST CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769
Mailing Address - Country:US
Mailing Address - Phone:407-892-5700
Mailing Address - Fax:321-805-4156
Practice Address - Street 1:3113-3115 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:ST CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769
Practice Address - Country:US
Practice Address - Phone:407-892-5700
Practice Address - Fax:321-805-4156
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE TRANSITION HOUSE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101335000Medicaid