NPIMap

Organization Active NPI

Transitions - Mental Health Association

Doing business as AG Wellness Center Safe Haven

  • Counselor
  • Arroyo Grande, CA
National Provider Identifier
1093997215
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
TRANSITIONS - MENTAL HEALTH ASSOCIATION
Doing business as
AG Wellness Center Safe Haven
Practice address
203 Bridge St
Arroyo Grande, CA 93420-3311
Phone
(805) 489-9659
Fax
(805) 540-6501
NPI assigned
Nov 29, 2007
Last updated
Dec 6, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
TRANSITIONS-MENTAL HEALTH ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Jill Bolster-White
Title
Executive Director
Phone
(805) 540-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

203 Bridge St
Arroyo Grande, CA 93420-3311

Mailing address

PO Box 15408
San Luis Obispo, CA 93406-5408
Phone (805) 540-6500

Other names 1

  • AG Wellness Center Safe Haven Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Transitions Mental Health28 organizations share this tax ID, including this one
Part of
Transitions Mental Health

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

203 Bridge St
Arroyo Grande, CA 93420
Phone (805) 489-9659

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1093997215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15408",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934065408",
            "telephone_number": "805-540-6500",
            "fax_number": "805-540-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 BRIDGE ST",
            "city": "ARROYO GRANDE",
            "state": "CA",
            "postal_code": "934203311",
            "telephone_number": "805-489-9659",
            "fax_number": "805-540-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSITIONS - MENTAL HEALTH ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRANSITIONS-MENTAL HEALTH ASSOCIATION",
        "enumeration_date": "2007-11-29",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "BOLSTER-WHITE",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "805-540-6500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AG Wellness Center Safe Haven",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arroyo Grande, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.