Provider Demographics
NPI:1487791364
Name:TRANSITIONS, INC.
Entity type:Organization
Organization Name:TRANSITIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:J KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEELE
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:208-524-8898
Mailing Address - Street 1:520 LOMAX ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-2634
Mailing Address - Country:US
Mailing Address - Phone:208-524-8898
Mailing Address - Fax:208-524-5039
Practice Address - Street 1:520 LOMAX ST
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-2634
Practice Address - Country:US
Practice Address - Phone:208-524-8898
Practice Address - Fax:208-524-5039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID8058590Medicaid
ID0027095Medicaid