Provider Demographics
NPI:1710554076
Name:TRANSITIONS - MENTAL HEALTH ASSOCIATION
Entity Type:Organization
Organization Name:TRANSITIONS - MENTAL HEALTH ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN K
Authorized Official - Middle Name:BOAZ
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-540-6587
Mailing Address - Street 1:1998 SANTA BARBARA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-4487
Mailing Address - Country:US
Mailing Address - Phone:805-592-2321
Mailing Address - Fax:
Practice Address - Street 1:7125 SANTA YSABEL AVE
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4513
Practice Address - Country:US
Practice Address - Phone:805-748-0854
Practice Address - Fax:805-592-2322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness