Provider Demographics
NPI:1235411802
Name:TRANSITIONS MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:TRANSITIONS MENTAL HEALTH SERVICES
Other - Org Name:TRANSITIONS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:E
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 2:805 19TH STREET
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61204-4238
Mailing Address - Country:US
Mailing Address - Phone:309-793-4993
Mailing Address - Fax:309-793-9053
Practice Address - Street 1:2326 16TH ST
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-4824
Practice Address - Country:US
Practice Address - Phone:309-793-4993
Practice Address - Fax:309-743-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007631251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health