Provider Demographics
NPI:1174986392
Name:TRANSITIONS YOUTH HOMES, LLC
Entity type:Organization
Organization Name:TRANSITIONS YOUTH HOMES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MPA
Authorized Official - Phone:316-371-6916
Mailing Address - Street 1:2426 E CONQUEST ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67219-4768
Mailing Address - Country:US
Mailing Address - Phone:316-371-6916
Mailing Address - Fax:316-440-5692
Practice Address - Street 1:2426 E CONQUEST ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67219-4768
Practice Address - Country:US
Practice Address - Phone:316-371-6916
Practice Address - Fax:316-440-5692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities