Provider Demographics
NPI:1962221952
Name:TRANSFORMATIONAL THERAPY SERVICES LLC
Entity type:Organization
Organization Name:TRANSFORMATIONAL THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TATIANA
Authorized Official - Middle Name:T
Authorized Official - Last Name:MACIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-351-6912
Mailing Address - Street 1:91-1888 LUAHOANA ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-5913
Mailing Address - Country:US
Mailing Address - Phone:808-351-6912
Mailing Address - Fax:
Practice Address - Street 1:458 MANAWAI ST APT 805
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4604
Practice Address - Country:US
Practice Address - Phone:808-494-4278
Practice Address - Fax:808-468-4907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty