Provider Demographics
NPI:1386829174
Name:TRANSITIONS - MENTAL HEALTH ASSOCIATION
Entity Type:Organization
Organization Name:TRANSITIONS - MENTAL HEALTH ASSOCIATION
Other - Org Name:SLO WELLNESS CENTER HOPE HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLSTER-WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-540-6500
Mailing Address - Street 1:PO BOX 15408
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93406-5408
Mailing Address - Country:US
Mailing Address - Phone:805-540-6500
Mailing Address - Fax:805-540-6501
Practice Address - Street 1:1306 NIPOMO ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3935
Practice Address - Country:US
Practice Address - Phone:805-541-6813
Practice Address - Fax:805-540-6501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSITIONS - MENTAL HEALTH ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-31
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty