Provider Demographics
NPI:1427606003
Name:T & K EARLY INTERVENTION
Entity Type:Organization
Organization Name:T & K EARLY INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-252-6066
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58402-0532
Mailing Address - Country:US
Mailing Address - Phone:701-320-6488
Mailing Address - Fax:701-252-6074
Practice Address - Street 1:102 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-4104
Practice Address - Country:US
Practice Address - Phone:701-320-6488
Practice Address - Fax:701-252-6074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-28
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency