Provider Demographics
NPI:1114179140
Name:TRANSITIONS BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:TRANSITIONS BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LMHC
Authorized Official - Phone:727-599-1343
Mailing Address - Street 1:PO BOX 697
Mailing Address - Street 2:
Mailing Address - City:INDIAN ROCKS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33785-0697
Mailing Address - Country:US
Mailing Address - Phone:727-599-1343
Mailing Address - Fax:727-848-4795
Practice Address - Street 1:6710 EMBASSY BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-7754
Practice Address - Country:US
Practice Address - Phone:727-599-1343
Practice Address - Fax:727-848-4795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9191302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization