Provider Demographics
NPI:1821536202
Name:THERAPEUTIC INTEGRATIVE SERVICES, INC.
Entity Type:Organization
Organization Name:THERAPEUTIC INTEGRATIVE SERVICES, INC.
Other - Org Name:TIS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:META
Authorized Official - Middle Name:KARLISE
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-618-4344
Mailing Address - Street 1:136 CLARENCE AVE
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-1604
Mailing Address - Country:US
Mailing Address - Phone:443-618-4344
Mailing Address - Fax:410-647-1537
Practice Address - Street 1:9535 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-2703
Practice Address - Country:US
Practice Address - Phone:443-618-4344
Practice Address - Fax:410-647-1537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services