Provider Demographics
NPI:1376832212
Name:INIZIO INTERVENTIONS, INC.
Entity Type:Organization
Organization Name:INIZIO INTERVENTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEARNS-ENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-521-0114
Mailing Address - Street 1:200 E DEL MAR BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2552
Mailing Address - Country:US
Mailing Address - Phone:818-937-0882
Mailing Address - Fax:818-937-0883
Practice Address - Street 1:200 E DEL MAR BLVD STE 112
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2552
Practice Address - Country:US
Practice Address - Phone:818-937-0882
Practice Address - Fax:818-937-0883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-31
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR8889095Medicaid