| Transformative Life Center, Llc. | |
|
130 W Matthews St Matthews NC 28105-1312 | |
| (704) 927-5885 | |
| Not Available |
| Full Name | Transformative Life Center, Llc. |
|---|---|
| Speciality | Psychologist |
| Location | 130 W Matthews St, Matthews, North Carolina |
| Authorized Official Name and Position | Rose Marie Leday (MANAGER) |
| Authorized Official Contact | 9804064393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformative Life Center, Llc. Po Box 1200 Matthews NC 28106-1200 Ph: (704) 927-5885 | Transformative Life Center, Llc. 130 W Matthews St Matthews NC 28105-1312 Ph: (704) 927-5885 |
| NPI Number | 1215259874 |
|---|---|
| Provider Enumeration Date | 02/24/2010 |
| Last Update Date | 05/15/2025 |
| Certification Date | 05/15/2025 |
| Medicare PECOS PAC ID | 2668665738 |
|---|---|
| Medicare Enrollment ID | O20101021000362 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215259874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 3909 (North Carolina) | Primary |
| Provider Name | Rose M Leday |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679805717 PECOS PAC ID: 4789719642 Enrollment ID: I20100317000261 |
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