Provider Demographics
NPI:1558934513
Name:TRANSCEND MENTAL BEHAVIOR GROUP, LLC
Entity Type:Organization
Organization Name:TRANSCEND MENTAL BEHAVIOR GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:CDCA
Authorized Official - Phone:216-926-8512
Mailing Address - Street 1:1414 S GREEN RD STE 307
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3976
Mailing Address - Country:US
Mailing Address - Phone:216-340-7484
Mailing Address - Fax:
Practice Address - Street 1:1414 S GREEN RD STE 307
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-3976
Practice Address - Country:US
Practice Address - Phone:216-340-7484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health