Provider Demographics
NPI:1306179700
Name:TRANSITIONAL WELLNESS CENTER
Entity Type:Organization
Organization Name:TRANSITIONAL WELLNESS CENTER
Other - Org Name:CATHY DONOVAN, LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DONOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:702-339-0346
Mailing Address - Street 1:437 ENGEL AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-4357
Mailing Address - Country:US
Mailing Address - Phone:702-339-0346
Mailing Address - Fax:
Practice Address - Street 1:5852 S PECOS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3489
Practice Address - Country:US
Practice Address - Phone:702-339-0346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2556-C251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health