Provider Demographics
NPI:1578135695
Name:TRANSFORMING LIVES COMMUNITY BEHAVIORAL HEALTH CENTER (TLC)
Entity Type:Organization
Organization Name:TRANSFORMING LIVES COMMUNITY BEHAVIORAL HEALTH CENTER (TLC)
Other - Org Name:UNK'S PLACE INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DENISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-979-1699
Mailing Address - Street 1:120 W 2ND ST STE 425
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-1623
Mailing Address - Country:US
Mailing Address - Phone:937-979-1699
Mailing Address - Fax:937-220-9298
Practice Address - Street 1:120 W 2ND ST STE 425
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1623
Practice Address - Country:US
Practice Address - Phone:937-979-1699
Practice Address - Fax:937-220-9298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)