Provider Demographics
NPI:1487971651
Name:TRANSITION HEALTHCARE,LLC
Entity type:Organization
Organization Name:TRANSITION HEALTHCARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR/ADMIN ASST
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACE
Authorized Official - Middle Name:LAYNE
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-697-4664
Mailing Address - Street 1:4601 EXCELSIOR BLVD
Mailing Address - Street 2:SUITE 503
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4960
Mailing Address - Country:US
Mailing Address - Phone:952-697-4660
Mailing Address - Fax:952-697-4661
Practice Address - Street 1:4601 EXCELSIOR BLVD
Practice Address - Street 2:SUITE 503
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-4960
Practice Address - Country:US
Practice Address - Phone:952-697-4660
Practice Address - Fax:952-697-4661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN251E00000X310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility