| Transformed Support Services | |
|
3959 Electric Rd Suite 350 Roanoke VA 24018-4562 | |
| (540) 685-2582 | |
| (540) 685-2583 |
| Full Name | Transformed Support Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3959 Electric Rd, Roanoke, Virginia |
| Authorized Official Name and Position | Susan Lawyer Willis (CEO) |
| Authorized Official Contact | 5403307228 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformed Support Services 3959 Electric Rd Suite 350 Roanoke VA 24018-4562 Ph: (540) 685-2582 | Transformed Support Services 3959 Electric Rd Suite 350 Roanoke VA 24018-4562 Ph: (540) 685-2582 |
| NPI Number | 1396086153 |
|---|---|
| Provider Enumeration Date | 03/04/2013 |
| Last Update Date | 03/04/2013 |
| Medicare PECOS PAC ID | 7416193941 |
|---|---|
| Medicare Enrollment ID | O20190320003065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396086153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Virginia) | Primary |
| Provider Name | Andrea G Haley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154415271 PECOS PAC ID: 0648337659 Enrollment ID: I20090318000570 |
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