1376998781 NPI number — TRANSITIONS INDIANA, LLC

Table of content: (NPI 1376998781)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376998781 NPI number — TRANSITIONS INDIANA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRANSITIONS INDIANA, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376998781
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8913 N PRAIRIE POINTE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEORIA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
61615-1577
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-515-1505
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8435 KEYSTONE CROSSING
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46240-4373
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-519-6145
Provider Business Practice Location Address Fax Number:
317-218-3504
Provider Enumeration Date:
05/04/2016

Additional Information

Authorized Official

Authorized Official Last Name:
KHAMIS
Authorized Official First Name:
OMAR
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
847-515-1505

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com