Organization
COMMUNITY TRANSITION ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA WATERS (EXECUTIVE DIRECTOR)
(858) 603-4812
Entity
Organization
Contact information
Practice address
625 PENNSYLVANIA AVE, SAN DIEGO, CA 92103-4321
(858) 603-4812
(619) 432-0048
Mailing address
PO BOX 720072, SAN DIEGO, CA 92172-0072
(858) 603-4812
(619) 432-0048
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/24/2018
Last updated
04/24/2018
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