Provider Demographics
NPI:1467905166
Name:TRANSFORMATION THERAPY INC
Entity Type:Organization
Organization Name:TRANSFORMATION THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:CORETTA
Authorized Official - Last Name:MERCHANT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:240-605-2882
Mailing Address - Street 1:3668 TURTLE ISLAND CT
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411
Mailing Address - Country:US
Mailing Address - Phone:240-605-2882
Mailing Address - Fax:
Practice Address - Street 1:3668 TURTLE ISLAND CT
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-6444
Practice Address - Country:US
Practice Address - Phone:240-605-2882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility