| Transitional Living Services, Inc | |
|
3710 Douglas Ave Racine WI 53402-3227 | |
| (262) 639-8084 | |
| (262) 639-8086 |
| Full Name | Transitional Living Services, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3710 Douglas Ave, Racine, Wisconsin |
| Authorized Official Name and Position | Robert Wrenn (PRESIDENT AND CEO) |
| Authorized Official Contact | 4144769615 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transitional Living Services, Inc 1040 S 70th St Milwaukee WI 53214-3174 Ph: (414) 476-9675 | Transitional Living Services, Inc 3710 Douglas Ave Racine WI 53402-3227 Ph: (262) 639-8084 |
| NPI Number | 1831381839 |
|---|---|
| Provider Enumeration Date | 08/14/2007 |
| Last Update Date | 08/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831381839 | NPI | - | NPPES |
| 43429700 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2112 (Wisconsin) | Primary |
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