# FBTC TRANSITIONAL SUB, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558240614
- **Authorized official:** MARY PATRICIA RODENBERG-ROBERTS (CHIEF REGULATORY OFFICER SR ASST GC)
- **Authorized official phone:** (952) 836-2234

## Contact information

- **Practice address:** 1 RANDALL SQ STE 302&307, PROVIDENCE, RI 02904-2709
- **Practice address phone:** (401) 443-5252
- **Mailing address:** 6600 FRANCE AVE S STE 350, EDINA, MN 55435-1810
- **Mailing address phone:** (800) 388-5150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | Yes |
| 261QH0700X | Hearing and Speech Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/01/2025
- **Last updated:** 09/23/2026