| Transitional Living | |
|
2052 Princeton Rd Fairfield Township OH 45011-4746 | |
| (513) 863-6383 | |
| (513) 863-9882 |
| Full Name | Transitional Living |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2052 Princeton Rd, Fairfield Township, Ohio |
| Authorized Official Name and Position | Scott Gehring (CEO) |
| Authorized Official Contact | 5138963441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Transitional Living 1020 Symmes Rd Fairfield OH 45014-1844 Ph: (513) 645-4578 | Transitional Living 2052 Princeton Rd Fairfield Township OH 45011-4746 Ph: (513) 863-6383 |
| NPI Number | 1689631046 |
|---|---|
| Provider Enumeration Date | 04/28/2006 |
| Last Update Date | 01/16/2024 |
| Certification Date | 01/16/2024 |
| Medicare PECOS PAC ID | 7911984414 |
|---|---|
| Medicare Enrollment ID | O20040701001673 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689631046 | NPI | - | NPPES |
| 0200955 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 519651 (Ohio) | Primary |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | RF-02-1931 (Ohio) | Secondary |
| Provider Name | Rakesh M Kaneria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740347566 PECOS PAC ID: 2567436637 Enrollment ID: I20040824000742 |
| Provider Name | Melinda Nieman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861595050 PECOS PAC ID: 8426005729 Enrollment ID: I20050407000743 |
| Provider Name | Ceilia M White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033284989 PECOS PAC ID: 1658473442 Enrollment ID: I20070226000281 |
| Provider Name | Elizabeth Erbeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215148796 PECOS PAC ID: 1850662867 Enrollment ID: I20170810000041 |
| Provider Name | Margaret Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326532748 PECOS PAC ID: 5092068031 Enrollment ID: I20181022001985 |
| Provider Name | Amy Crouch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114387552 PECOS PAC ID: 8527397520 Enrollment ID: I20190916002675 |
| Provider Name | Natasha Schreiber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023537636 PECOS PAC ID: 1456739960 Enrollment ID: I20220610001841 |
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