Organization
TRANSITIONAL SERVICES SUB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT IAN COHEN (COO)
(800) 388-5150
Entity
Organization
Contact information
Practice address
4812 W STATE ROAD 45, BLOOMINGTON, IN 47403-9341
(812) 825-5038
(317) 581-2378
Mailing address
9000 KEYSTONE XING STE 200, INDIANAPOLIS, IN 46240-2148
(317) 581-2380
(317) 581-2378
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2539B0009JN08
IN
Other
Enumeration date
06/05/2008
Last updated
04/18/2023
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