Provider Demographics
NPI:1366031288
Name:TOLA INTEGRATION SERVICES LLP
Entity Type:Organization
Organization Name:TOLA INTEGRATION SERVICES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-347-1635
Mailing Address - Street 1:41328 E VILLAGE GREEN BLVD APT 204
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3891
Mailing Address - Country:US
Mailing Address - Phone:954-347-1635
Mailing Address - Fax:
Practice Address - Street 1:41328 E VILLAGE GREEN BLVD APT 204
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3891
Practice Address - Country:US
Practice Address - Phone:954-347-1635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty