Provider Demographics
NPI:1154581130
Name:TRANSFORMING RESOURCES
Entity type:Organization
Organization Name:TRANSFORMING RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KIP
Authorized Official - Middle Name:
Authorized Official - Last Name:WAHLQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-884-5803
Mailing Address - Street 1:10800 LYNDALE AVE S
Mailing Address - Street 2:SUITE #191
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-5614
Mailing Address - Country:US
Mailing Address - Phone:952-884-5803
Mailing Address - Fax:
Practice Address - Street 1:10800 LYNDALE AVE S
Practice Address - Street 2:SUITE #191
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-5614
Practice Address - Country:US
Practice Address - Phone:952-884-5803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health