Provider Demographics
NPI:1316131071
Name:TRANSITIONAL LIVINING AND COMMUNITY SUPPORT
Entity type:Organization
Organization Name:TRANSITIONAL LIVINING AND COMMUNITY SUPPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAROLS PLACE ADVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-448-7391
Mailing Address - Street 1:2223 EDISON AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-1654
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2223 EDISON AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-1654
Practice Address - Country:US
Practice Address - Phone:916-448-7391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management