Provider Demographics
NPI:1316532641
Name:TRANSITIONAL THERAPEUTIC SERVICES, LLC
Entity type:Organization
Organization Name:TRANSITIONAL THERAPEUTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LCASA, LCSWA
Authorized Official - Phone:252-767-1011
Mailing Address - Street 1:300 SOUTHTOWN CIR STE 15
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-9573
Mailing Address - Country:US
Mailing Address - Phone:252-767-1011
Mailing Address - Fax:
Practice Address - Street 1:300 SOUTHTOWN CIR STE 15
Practice Address - Street 2:
Practice Address - City:ROLESVILLE
Practice Address - State:NC
Practice Address - Zip Code:27571-9573
Practice Address - Country:US
Practice Address - Phone:252-767-1011
Practice Address - Fax:919-435-8070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty