Provider Demographics
NPI:1871130799
Name:TRANSFORMATIVE CENTER FOR HEALING, LLC
Entity type:Organization
Organization Name:TRANSFORMATIVE CENTER FOR HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TATIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOSE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:214-300-8047
Mailing Address - Street 1:5999 CUSTER RD STE 110-118
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-9302
Mailing Address - Country:US
Mailing Address - Phone:214-300-8047
Mailing Address - Fax:
Practice Address - Street 1:5999 CUSTER RD STE 110-118
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-9302
Practice Address - Country:US
Practice Address - Phone:214-300-8047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-10
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty