Organization
DIRECT INTERVENTIONS SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL JOHNSON (PRESIDENT)
(336) 262-4400
Entity
Organization
Contact information
Practice address
211 MASSACHUSETTES AVE., NORTH WILKESBORO, NC 28659
(336) 262-4400
Mailing address
211 MASSACHUSETTES AVE., NORTH WILKESBORO, NC 28659
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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