Transformation360 LLC
Community/Behavioral Health in Las Vegas, NV. Organization (NPI-2).
NPI number1144720657
StatusActive
Last updated in NPPESFeb 20, 2018
Details
- NPI
- 1144720657
- Entity type
- Organization (NPI-2)
- Legal business name
- Transformation360 LLC
- Organization subpart
- No
- Enumeration date
- Feb 20, 2018
- Last updated
- Feb 20, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
5025 Hostetler AveLas Vegas, NV 89131-1981
Phone 702-969-5970
Mailing address
5025 Hostetler AveLas Vegas, NV 89131-1981
Phone 702-969-5970
Authorized official
Alice Delia Peterson
Owner
7029695970
Is something wrong?
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