Provider Demographics
NPI:1851589063
Name:POSITIVE INTERVENTION THERAPEUTIC SERVICES INCORPORATED
Entity Type:Organization
Organization Name:POSITIVE INTERVENTION THERAPEUTIC SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JOHNSON
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-588-4685
Mailing Address - Street 1:8032 OLD FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28441-8946
Mailing Address - Country:US
Mailing Address - Phone:910-588-4685
Mailing Address - Fax:
Practice Address - Street 1:315 MARTIN LUTHER KING DRIVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337
Practice Address - Country:US
Practice Address - Phone:910-536-2253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management