Provider Demographics
NPI:1164940052
Name:TRANSITIONS RECOVERY CENTER
Entity Type:Organization
Organization Name:TRANSITIONS RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:SHEA
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-378-8502
Mailing Address - Street 1:PO BOX 370485
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30037-0485
Mailing Address - Country:US
Mailing Address - Phone:470-378-8502
Mailing Address - Fax:
Practice Address - Street 1:2855 CANDLER RD STE 16
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-1415
Practice Address - Country:US
Practice Address - Phone:470-378-8502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility