Healthcare Provider Details

I. General information

NPI: 1972323152
Provider Name (Legal Business Name): TIERED SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3562 E US HIGHWAY 30
WARSAW IN
46580-6720
US

IV. Provider business mailing address

748 DOGWOOD LN
WARSAW IN
46582-1905
US

V. Phone/Fax

Practice location:
  • Phone: 574-252-1922
  • Fax:
Mailing address:
  • Phone: 574-252-1922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JONNA WATSON
Title or Position: MANAGER/SCHOOL PSYCHOLOGIST
Credential: ED.S.
Phone: 574-252-1922