Provider Demographics
NPI:1295905362
Name:TRANSITIONAL LEARNING CENTER AT GALVESTON
Entity type:Organization
Organization Name:TRANSITIONAL LEARNING CENTER AT GALVESTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:EPPINETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-762-6661
Mailing Address - Street 1:1275 SPACE PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3311
Mailing Address - Country:US
Mailing Address - Phone:409-797-1454
Mailing Address - Fax:409-743-3430
Practice Address - Street 1:1808 N QUAKER AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-2743
Practice Address - Country:US
Practice Address - Phone:409-797-1443
Practice Address - Fax:409-797-1414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE TRANSITIONAL LEARNING CENTER GALVESTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-05
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0401X, 3104A0625X
TX140173310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX307377OtherTEXAS HEALTH & HUMAN SERVICES ASSISTED LIVING FACILITY LICENSE