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General NPI Number Information
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NPI Number | 1538720396
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Entity Type | Organization
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Legal Business Name | ADAPTIVE INTERVENTIONS GROUP, LLC
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Dates
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Enumeration Date | 06/24/2019
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 107 ROBINSON DR
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City | CHERRYVILLE
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State | NC
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Zip | 28021-8100
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Country | US
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Telephone | 704-789-3029
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Fax | 800-292-0277
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Provider Business Mailing Address
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Address Line | 1660 STANLEY LUCIA RD
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-9735
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Country | US
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Telephone | 980-448-4614
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | KEVI CUNNINGHAM
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Credential |
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Telephone | 980-448-4614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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