Provider Demographics
NPI:1669931051
Name:POSITIVE TRANSFORMATIONS HEALTH SERVICES
Entity type:Organization
Organization Name:POSITIVE TRANSFORMATIONS HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAISHA
Authorized Official - Middle Name:RONEAL
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:985-313-1093
Mailing Address - Street 1:2590 HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-5843
Mailing Address - Country:US
Mailing Address - Phone:985-313-1093
Mailing Address - Fax:985-313-1092
Practice Address - Street 1:2590 HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-5843
Practice Address - Country:US
Practice Address - Phone:985-313-1093
Practice Address - Fax:985-313-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)