Provider Demographics
NPI:1134841919
Name:4 ALL OF US TRANSITIONAL IMPROVEMENTS, INC
Entity type:Organization
Organization Name:4 ALL OF US TRANSITIONAL IMPROVEMENTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-218-3326
Mailing Address - Street 1:712 RENCHER ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-6560
Mailing Address - Country:US
Mailing Address - Phone:575-218-3325
Mailing Address - Fax:575-218-3326
Practice Address - Street 1:712 RENCHER ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-6560
Practice Address - Country:US
Practice Address - Phone:575-218-3325
Practice Address - Fax:575-218-3326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM6908179OtherSOS