Provider Demographics
NPI:1083727481
Name:TRANSITIONS NFP
Entity Type:Organization
Organization Name:TRANSITIONS NFP
Other - Org Name:TRANSITIONS MENTAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:309-283-1206
Mailing Address - Street 1:PO BOX 4238
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61204-4238
Mailing Address - Country:US
Mailing Address - Phone:309-283-1224
Mailing Address - Fax:309-283-0151
Practice Address - Street 1:805 19TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-2514
Practice Address - Country:US
Practice Address - Phone:309-793-4993
Practice Address - Fax:309-793-9053
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSITIONS NFP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========004Medicaid
IL=========006Medicaid
IL=========005Medicaid