Provider Demographics
NPI:1336207802
Name:TRANSITIONS MENTAL HEALTH
Entity Type:Organization
Organization Name:TRANSITIONS MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESOURCE SPECIALIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:DENISSE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-541-5144
Mailing Address - Street 1:1586 PALOMA PL
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-5176
Mailing Address - Country:US
Mailing Address - Phone:805-473-3150
Mailing Address - Fax:
Practice Address - Street 1:277 SOUTH ST STE Y
Practice Address - Street 2:BOX 15408
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-5039
Practice Address - Country:US
Practice Address - Phone:805-541-5144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)