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General NPI Number Information
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NPI Number | 1770188047
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC INTERVENTION SERVICES, INC.
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 04/25/2022
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Provider Practice Location Address
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Address Line | 340 N SAM HOUSTON PKWY E STE A217
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City | HOUSTON
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State | TX
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Zip | 77060-3305
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Country | US
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Telephone | 252-258-4783
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Fax |
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Provider Business Mailing Address
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Address Line | 4803 RED BRUSH DR
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City | MC LEANSVILLE
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State | NC
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Zip | 27301-9314
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPERATIONS
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Name | ANTWAN ADAMS
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Credential |
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Telephone | 252-258-4783
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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 |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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