Provider Demographics
NPI:1689923559
Name:TRANSITIONS MENTAL HEALTH ASSOCIATION
Entity type:Organization
Organization Name:TRANSITIONS MENTAL HEALTH ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLSTER-WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-540-6500
Mailing Address - Street 1:5850 WEST MALL
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4239
Mailing Address - Country:US
Mailing Address - Phone:805-464-0512
Mailing Address - Fax:
Practice Address - Street 1:5850 WEST MALL
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-4239
Practice Address - Country:US
Practice Address - Phone:805-464-0512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSITIONS- MENTAL HEALTH ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-06
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness