Provider Demographics
NPI:1982595500
Name:TRANSFORMATIVE SERVICES LLC
Entity type:Organization
Organization Name:TRANSFORMATIVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REPORTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PREM
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-301-1936
Mailing Address - Street 1:901 42ND ST S APT 213
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-2156
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 42ND ST S APT 213
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-2156
Practice Address - Country:US
Practice Address - Phone:502-301-1936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty