NPIMap

Organization Active NPI

Transformation Health, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Odenton, MD
National Provider Identifier
1700599586
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
TRANSFORMATION HEALTH, LLC
Practice address
2288 Blue Water Blvd Ste 315&317
Odenton, MD 21113-3309
Phone
(443) 759-9592
NPI assigned
Dec 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Authorized official

Name
Monica Laney Boddie, LCSW-CNPI 1396977872
Title
Ceo
Phone
(443) 224-3002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

2288 Blue Water Blvd Ste 315&317
Odenton, MD 21113-3309

Mailing address

4083 Dorseys Ridge SQ
Ellicott City, MD 21043-5469
Phone (443) 224-3002

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.mytransformationhealth.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Transformation Health LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1700599586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4083 DORSEYS RIDGE SQ",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210435469",
            "telephone_number": "443-224-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 BLUE WATER BLVD STE 315&317",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211133309",
            "telephone_number": "443-759-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATION HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "BODDIE",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "LANEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-224-3002",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.mytransformationhealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "2288 Blue Water Blvd Ste 315&317",
            "city": "Odenton",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211133309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Odenton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.