Transitional Living Center

NPI 1235527524 - Clinic/Center - 261QM0850X

NPI Details
NPI 1235527524
Enumeration Date 01/08/2015
Last Updated 01/08/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name DIANA DIANA
Position PRESIDENT/CEO
Phone (217) 423-0548
Fax (217) 632-6290
Practice Location
327 W PRAIRIE AVE
DECATUR IL, 62522-2444, US
Phone (217) 423-0548
Fax (217) 632-6290
Business Location
151 N MAIN ST
DECATUR IL, 62523-1206, US
Phone (217) 362-6262
Fax (217) 362-6290
Toxanomy
Taxonomy Code 261QM0850X
License State Illinois
License Number 04070
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According to our database, Transitional Living Center NPI is 1235527524, taxonomy code is 261QM0850X and license number is 04070, license state is located at Illinois. Transitional Living Center physically located at 327 W Prairie Ave, Decatur IL, 62522-2444. NPI Number 1033115704 has the healthcare provider type.

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1235527524 NPI number is provided on an as is basis without warranty of any kind. 1235527524 is maintained by the National Plan & Provider Enumeration System. The contents of Transitional Living Center are for informational purposes only.