Provider Demographics
NPI:1124691944
Name:TRANSFORMATIONS CARE INC
Entity type:Organization
Organization Name:TRANSFORMATIONS CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLENBACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-946-8433
Mailing Address - Street 1:18726 S WESTERN AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-3813
Mailing Address - Country:US
Mailing Address - Phone:310-946-8433
Mailing Address - Fax:
Practice Address - Street 1:18726 S WESTERN AVE STE 209
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-3813
Practice Address - Country:US
Practice Address - Phone:310-946-8433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSFORMATIONS CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-20
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility