Organization
TRANSITIONAL LIVING SERVICES, INC
Active
Parent organization
TRANSITIONAL LIVING SERVICES, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRANSITIONAL LIVING SERVICES, INC
Authorized official
ROBERT E WRENN (PRESIDENT AND CEO)
(414) 476-9631
Entity
Organization
Contact information
Practice address
3710 DOUGLAS AVE, RACINE, WI 53402-3227
(262) 639-8084
(262) 639-8086
Mailing address
1040 S 70TH ST, MILWAUKEE, WI 53214-3164
(414) 476-9675
(414) 615-0627
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42219500
—
WI
01
—
DD9253
RAILROAD MEDICARE PART B
WI
Enumeration date
06/15/2006
Last updated
02/19/2008
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