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General NPI Number Information
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NPI Number | 1003046947
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Entity Type | Organization
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Legal Business Name | INTERVENTION SERVICES INC.
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Dates
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Enumeration Date | 07/24/2009
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Last Update Date | 07/24/2009
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Provider Practice Location Address
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Address Line | 804 N HOAGLAND BLVD.
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City | KISSIMMEE
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State | FL
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Zip | 34741
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Country | US
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Telephone | 407-931-2911
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Fax |
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Provider Business Mailing Address
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Address Line | 804 N HOAGLAND BLVD
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City | KISSIMMEE
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State | FL
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Zip | 34741-4518
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Country | US
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Telephone | 407-931-2911
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | IVELISSE RIVERA
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Credential | M.A.
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Telephone | 321-663-8755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | FL
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