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General NPI Number Information
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NPI Number | 1851589063
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Entity Type | Organization
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Legal Business Name | POSITIVE INTERVENTION THERAPEUTIC SERVICES INCORPORATED
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 315 MARTIN LUTHER KING DRIVE
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337
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Country | US
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Telephone | 910-536-2253
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Fax |
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Provider Business Mailing Address
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Address Line | 8032 OLD FAYETTEVILLE RD
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City | GARLAND
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State | NC
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Zip | 28441-8946
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Country | US
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Telephone | 910-588-4685
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Fax |
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Authorized Official
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Title or Position | CHEIF EXECUTIVE OF OPERATIONS
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Name | MRS. LINDA JOHNSON BALDWIN
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Credential |
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Telephone | 910-588-4685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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