Provider Demographics
NPI:1477713501
Name:TRANSITIONAL LIVING INC
Entity Type:Organization
Organization Name:TRANSITIONAL LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECURITY OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:DEMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-645-4585
Mailing Address - Street 1:2052 PRINCETON RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-4746
Mailing Address - Country:US
Mailing Address - Phone:513-863-6383
Mailing Address - Fax:513-863-9882
Practice Address - Street 1:2052 PRINCETON RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-4746
Practice Address - Country:US
Practice Address - Phone:513-863-6383
Practice Address - Fax:513-863-9882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH519651251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1811974751OtherJEFFREY MARSHALL BISHOP, MD NPI NUMBER
OH0719039Medicaid
OH6783OtherMACSIS UPIN
OH0719039Medicaid