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Organization
TLC TRANSITIONS LIFE CENTER LLC
Active
Organization
TLC TRANSITIONS LIFE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY CHRISTINE MAHANA PSY.D., HSPP (CLINICAL PSYCHOLOGIST)
(417) 838-3490
Entity
Organization
Contact information
Practice address
3224 S LAFOUNTAIN ST STE B, KOKOMO, IN 46902-3714
(417) 838-3490
Mailing address
3224 S LAFOUNTAIN ST STE B, KOKOMO, IN 46902-3714
(417) 838-3490
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
20043022A
IN
Other
Enumeration date
07/07/2017
Last updated
07/07/2017
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