Provider Demographics
NPI:1760085096
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:410-878-1085
Mailing Address - Street 1:326 SAINT PAUL ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2166
Mailing Address - Country:US
Mailing Address - Phone:410-878-1084
Mailing Address - Fax:
Practice Address - Street 1:4606 YORK RD UPPR FLOOR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-4707
Practice Address - Country:US
Practice Address - Phone:420-878-1085
Practice Address - Fax:443-388-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness