Healthcare Provider Details

I. General information

NPI: 1104377993
Provider Name (Legal Business Name): EARLY LEARNING INTERVENTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2016
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7234 PRICE PT
DENVER NC
28037-8019
US

IV. Provider business mailing address

7234 PRICE PT
DENVER NC
28037-8019
US

V. Phone/Fax

Practice location:
  • Phone: 828-773-4806
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: LAURA ASHLYN SIGMON
Title or Position: OWNER
Credential:
Phone: 828-773-4806