Healthcare Provider Details

I. General information

NPI: 1518950815
Provider Name (Legal Business Name): THERAPEUTIC INTERVENTION PROGRAMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10721 SMETANA RD SUITE 220
MINNETONKA MN
55343-8080
US

IV. Provider business mailing address

10721 SMETANA RD SUITE 220
MINNETONKA MN
55343-8080
US

V. Phone/Fax

Practice location:
  • Phone: 952-936-9215
  • Fax: 952-936-9942
Mailing address:
  • Phone: 952-936-9215
  • Fax: 952-936-9942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number03158
License Number StateMN

VIII. Authorized Official

Name: DR. PATRICIA C. MONTGOMERY
Title or Position: PRESIDENT
Credential: PHD, PT
Phone: 952-936-9215