MEDICARE: INTERVENTION RESOURCES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	12463	TX

General Provider Information

NPI Number	:	1245418854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERVENTION RESOURCES, INC

Provider Business Mailing Address
First Line	:	PO BOX 590328
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77259-0328
Country	:	US
Telephone Number	:	281-461-6940
Fax Number	:	281-461-6941

Provider Business Practice Location Address
First Line	:	16815 ROYAL CREST DR
Second Line	:	SUITE 140
City	:	HOUSTON
State	:	TX
Zip	:	77058-2521
Country	:	US
Telephone Number	:	281-461-6940
Fax Number	:	281-461-6941

Authorized Official
Title or Position	:	OWNER
Name	:	CONSTANCE K AUSTIN
Credential	:	LPC
Telephone Number	:	281-461-6940

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	02/06/2008

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