Provider Demographics
NPI:1518562842
Name:TRANSFORMATION HEALTHCARE INC.
Entity Type:Organization
Organization Name:TRANSFORMATION HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CALISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-878-1084
Mailing Address - Street 1:6801 OAK HALL LN UNIT 6462
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-7587
Mailing Address - Country:US
Mailing Address - Phone:240-374-3801
Mailing Address - Fax:410-755-7797
Practice Address - Street 1:6212 YORK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2612
Practice Address - Country:US
Practice Address - Phone:240-374-3801
Practice Address - Fax:410-755-7797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No251S00000XAgenciesCommunity/Behavioral Health