Provider Demographics
NPI:1336770619
Name:ALTRUISTIC TRANSITION AGENCY
Entity type:Organization
Organization Name:ALTRUISTIC TRANSITION AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:HAILE
Authorized Official - Last Name:FISSEHAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-372-9873
Mailing Address - Street 1:9825 E GIRARD AVE APT 18W217
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5529
Mailing Address - Country:US
Mailing Address - Phone:720-372-9873
Mailing Address - Fax:
Practice Address - Street 1:11111 E MISSISSIPPI AVE STE 280
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3106
Practice Address - Country:US
Practice Address - Phone:720-535-7143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management