Provider Demographics
NPI:1346557808
Name:DELIBERATE TRANSITION
Entity Type:Organization
Organization Name:DELIBERATE TRANSITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE OFFICER/ MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-464-9420
Mailing Address - Street 1:757 NE RAINTREE AVE
Mailing Address - Street 2:
Mailing Address - City:PINETTA
Mailing Address - State:FL
Mailing Address - Zip Code:32350-2558
Mailing Address - Country:US
Mailing Address - Phone:850-464-9420
Mailing Address - Fax:850-929-3031
Practice Address - Street 1:757 NE RAINTREE AVE
Practice Address - Street 2:
Practice Address - City:PINETTA
Practice Address - State:FL
Practice Address - Zip Code:32350-2558
Practice Address - Country:US
Practice Address - Phone:850-464-9420
Practice Address - Fax:850-929-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-04
Last Update Date:2010-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL231514311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility