Provider Demographics
NPI:1417350687
Name:UNITED INTERVENTIONS INC
Entity Type:Organization
Organization Name:UNITED INTERVENTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JENAE
Authorized Official - Middle Name:JERAN
Authorized Official - Last Name:HOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-331-3485
Mailing Address - Street 1:140 W WASHINGTON ST
Mailing Address - Street 2:SUITE 102B
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-5254
Mailing Address - Country:US
Mailing Address - Phone:757-925-3747
Mailing Address - Fax:
Practice Address - Street 1:140 W WASHINGTON ST
Practice Address - Street 2:SUITE 102B
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5254
Practice Address - Country:US
Practice Address - Phone:757-925-3747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2155251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health