Provider Demographics
NPI:1265058234
Name:TRANSCENDIA HEALTH SYSTEMS
Entity type:Organization
Organization Name:TRANSCENDIA HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-563-2817
Mailing Address - Street 1:3618 WAGON WHEEL RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-9512
Mailing Address - Country:US
Mailing Address - Phone:252-563-2817
Mailing Address - Fax:252-303-5430
Practice Address - Street 1:3618 WAGON WHEEL RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-9512
Practice Address - Country:US
Practice Address - Phone:252-563-2817
Practice Address - Fax:252-303-5430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC85-1593772Medicaid