Provider Demographics
NPI:1497110944
Name:LIFE TRANSITIONS INC.
Entity Type:Organization
Organization Name:LIFE TRANSITIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-833-8624
Mailing Address - Street 1:1020 RANKIN ST
Mailing Address - Street 2:SUITE 412
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-3700
Mailing Address - Country:US
Mailing Address - Phone:910-833-8624
Mailing Address - Fax:910-833-8625
Practice Address - Street 1:1020 RANKIN ST
Practice Address - Street 2:SUITE 412
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-3700
Practice Address - Country:US
Practice Address - Phone:910-833-8624
Practice Address - Fax:910-833-8625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2848101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC60083Medicaid