| The Transition House Of Indiana, Inc. | |
|
10531 E 10th St Indianapolis IN 46229-2604 | |
| (407) 892-5700 | |
| Not Available |
| Full Name | The Transition House Of Indiana, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 10531 E 10th St, Indianapolis, Indiana |
| Authorized Official Name and Position | Jennifer Reid Dellasanta (COO) |
| Authorized Official Contact | 7742532575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Transition House Of Indiana, Inc. 3800 5th St Saint Cloud FL 34769-2024 Ph: (407) 892-5700 | The Transition House Of Indiana, Inc. 10531 E 10th St Indianapolis IN 46229-2604 Ph: (407) 892-5700 |
| NPI Number | 1043775034 |
|---|---|
| Provider Enumeration Date | 02/05/2019 |
| Last Update Date | 08/26/2024 |
| Certification Date | 08/26/2024 |
| Medicare PECOS PAC ID | 7911337555 |
|---|---|
| Medicare Enrollment ID | O20200422000297 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043775034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Lisa K Riggs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891027736 PECOS PAC ID: 6800922691 Enrollment ID: I20100331000685 |
| Provider Name | Jaymes Gonzales |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598019838 PECOS PAC ID: 2961765151 Enrollment ID: I20200422000439 |
| Provider Name | Todd William Hollibush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780184168 PECOS PAC ID: 3173870755 Enrollment ID: I20200422000601 |
| Provider Name | Kimberly Quigley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619041803 PECOS PAC ID: 9638189442 Enrollment ID: I20200422002001 |
| Provider Name | Latoya C Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235804642 PECOS PAC ID: 3274924469 Enrollment ID: I20211223000094 |
| Provider Name | Laura Dearmond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982195095 PECOS PAC ID: 8123405362 Enrollment ID: I20220510000490 |
| Provider Name | Ashley Lawhorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740638733 PECOS PAC ID: 0143509448 Enrollment ID: I20220714001287 |
| Provider Name | Melissa Mcfall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063967354 PECOS PAC ID: 0941659346 Enrollment ID: I20231211002280 |
| Provider Name | Victoria Ariana Schluchter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154192235 PECOS PAC ID: 2365886439 Enrollment ID: I20240216000283 |
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