Provider Demographics
NPI:1851023329
Name:TRANSITIONS THRU LIFE, INC.
Entity Type:Organization
Organization Name:TRANSITIONS THRU LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CC (CELISE)
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ROXBY
Authorized Official - Suffix:
Authorized Official - Credentials:BSS, BSP
Authorized Official - Phone:304-559-3199
Mailing Address - Street 1:445 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BENWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26031-1105
Mailing Address - Country:US
Mailing Address - Phone:304-559-3199
Mailing Address - Fax:
Practice Address - Street 1:445 MAIN ST
Practice Address - Street 2:
Practice Address - City:BENWOOD
Practice Address - State:WV
Practice Address - Zip Code:26031-1105
Practice Address - Country:US
Practice Address - Phone:304-232-4411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVF533658OtherDRIVER'S LICENSE
WVF533658Medicaid