Organization Active NPI

Transitional Life, LLC

  • Community/Behavioral Health Agency
  • Matthews, NC
National Provider Identifier
1417301045
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
TRANSITIONAL LIFE, LLC
Practice address
4202 Painted Trillium CT
Matthews, NC 28105-0120
Phone
(704) 904-1770
NPI assigned
Apr 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Authorized official

Name
Ms. Nicole Denise Gomez
Title
Ceo
Phone
(704) 904-1770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NC Primary

Addresses

Primary practice location

4202 Painted Trillium CT
Matthews, NC 28105-0120

Mailing address

4202 Painted Trillium CT
Matthews, NC 28105-0120

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1417301045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 PAINTED TRILLIUM CT",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281050120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 PAINTED TRILLIUM CT",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281050120",
            "telephone_number": "704-904-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSITIONAL LIFE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-904-1770",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; 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.