Provider Demographics
NPI:1427088749
Name:TRANSITIONS CENTER LLC
Entity type:Organization
Organization Name:TRANSITIONS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LMFT,LPC,CADC
Authorized Official - Phone:715-365-6696
Mailing Address - Street 1:PO BOX 622
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-0622
Mailing Address - Country:US
Mailing Address - Phone:715-365-6696
Mailing Address - Fax:715-365-6768
Practice Address - Street 1:22 N PELHAM ST
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-3148
Practice Address - Country:US
Practice Address - Phone:715-365-6696
Practice Address - Fax:715-365-6768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4249-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42244000Medicaid
WI44050Medicare PIN