Provider Demographics
NPI:1154157402
Name:TRANSCENDENCE PERSONAL GROWTH AND DEVELOPMENT SERVICES LLC
Entity type:Organization
Organization Name:TRANSCENDENCE PERSONAL GROWTH AND DEVELOPMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-654-2017
Mailing Address - Street 1:3901 W 86TH ST STE 360
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1799
Mailing Address - Country:US
Mailing Address - Phone:317-654-2017
Mailing Address - Fax:
Practice Address - Street 1:3901 W 86TH ST STE 360
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1799
Practice Address - Country:US
Practice Address - Phone:317-654-2017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health