| Transitions In Lyfe | |
|
173 Fairmont Cir Kannapolis NC 28083-7819 | |
| (843) 260-4904 | |
| (704) 469-4714 |
| Full Name | Transitions In Lyfe |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 173 Fairmont Cir, Kannapolis, North Carolina |
| Authorized Official Name and Position | Candice Regina Johnson (CEO) |
| Authorized Official Contact | 8432604904 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Transitions In Lyfe 173 Fairmont Cir Kannapolis NC 28083-7819 Ph: (843) 260-4904 | Transitions In Lyfe 173 Fairmont Cir Kannapolis NC 28083-7819 Ph: (843) 260-4904 |
| NPI Number | 1700259926 |
|---|---|
| Provider Enumeration Date | 11/10/2015 |
| Last Update Date | 11/10/2015 |
| Medicare PECOS PAC ID | 9234540220 |
|---|---|
| Medicare Enrollment ID | O20201123003353 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700259926 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (North Carolina) | Primary |
| Provider Name | Almaz A Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811167232 PECOS PAC ID: 4486724135 Enrollment ID: I20090504000663 |
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