Provider Demographics
NPI:1164209854
Name:TRANSFORMATIVE COMMUNITY HEALTH INC
Entity Type:Organization
Organization Name:TRANSFORMATIVE COMMUNITY HEALTH INC
Other - Org Name:TRANSFORMATIVE GROWTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ETHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMECHEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-423-6010
Mailing Address - Street 1:24W500 MAPLE AVE STE 216A
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6057
Mailing Address - Country:US
Mailing Address - Phone:630-423-6010
Mailing Address - Fax:844-270-7898
Practice Address - Street 1:24W500 MAPLE AVE STE 216A
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6057
Practice Address - Country:US
Practice Address - Phone:630-423-6010
Practice Address - Fax:844-270-7898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty