Provider Demographics
NPI:1649543802
Name:SPRINGS TRANSITION HOME& FAMILY SERVICE
Entity type:Organization
Organization Name:SPRINGS TRANSITION HOME& FAMILY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GIOVONNI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-334-7858
Mailing Address - Street 1:1801 N TRYON ST STE 603
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-2781
Mailing Address - Country:US
Mailing Address - Phone:704-713-8283
Mailing Address - Fax:888-255-6081
Practice Address - Street 1:1801 N TRYON ST STE 603
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-2781
Practice Address - Country:US
Practice Address - Phone:704-713-8283
Practice Address - Fax:888-255-6081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-20
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3385305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization