Provider Demographics
NPI:1629227178
Name:MAV INTERVENTIONS
Entity Type:Organization
Organization Name:MAV INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:BA, JD
Authorized Official - Phone:910-565-2522
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-0399
Mailing Address - Country:US
Mailing Address - Phone:910-565-2522
Mailing Address - Fax:888-848-1195
Practice Address - Street 1:109 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3351
Practice Address - Country:US
Practice Address - Phone:910-565-2522
Practice Address - Fax:888-848-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health