Provider Demographics
NPI:1215017215
Name:TRANSITION HOME HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:TRANSITION HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:COLWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-687-2610
Mailing Address - Street 1:300 GLEED AVE
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2980
Mailing Address - Country:US
Mailing Address - Phone:716-687-2610
Mailing Address - Fax:716-687-2710
Practice Address - Street 1:1706 MEDICAL ARTS DR
Practice Address - Street 2:SUITE 5
Practice Address - City:HUNTINGBURG
Practice Address - State:IN
Practice Address - Zip Code:47542-9049
Practice Address - Country:US
Practice Address - Phone:812-683-6410
Practice Address - Fax:812-683-6403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06-005362-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100265120Medicaid
IN157200Medicare Oscar/Certification