Provider Demographics
NPI:1528584398
Name:JRTRANSI, LLC
Entity Type:Organization
Organization Name:JRTRANSI, LLC
Other - Org Name:JRTRANSI, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:BA,ED
Authorized Official - Phone:304-960-9348
Mailing Address - Street 1:10935 EMERALD WOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-2419
Mailing Address - Country:US
Mailing Address - Phone:304-960-9348
Mailing Address - Fax:304-960-9348
Practice Address - Street 1:10935 EMERALD WOOD DR
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-2419
Practice Address - Country:US
Practice Address - Phone:304-960-9348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 323P00000X
NCCCSI20285320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility