Organization
THERAPEUTIC INTERVENTION EARLY SERVICES, INC.
Active
Other names
Therapeutic Intervention Early Service, inc.
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LOCKE (PRESIDENT)
(754) 204-0312
Entity
Organization
Contact information
Practice address
9470 LIVE OAK PL APT 405, DAVIE, FL 33324-4747
(754) 204-0312
(954) 302-1830
Mailing address
9470 LIVE OAK PL, DAVIE, FL 33324-4769
(754) 204-0312
(954) 302-1830
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
CAP3324
FL
251C00000X
Developmentally Disabled Services Day Training Agency
SW9510
FL
251S00000X
Community/Behavioral Health Agency
Primary
SW9510
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
761451900
—
FL
Enumeration date
07/10/2009
Last updated
04/20/2021
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