Provider Demographics
NPI:1013034321
Name:THERAPEUTIC SERVICES GROUP
Entity type:Organization
Organization Name:THERAPEUTIC SERVICES GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:STUCCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-849-8621
Mailing Address - Street 1:6621 AUGUSTINE WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-0891
Mailing Address - Country:US
Mailing Address - Phone:704-849-8621
Mailing Address - Fax:704-849-7349
Practice Address - Street 1:6621 AUGUSTINE WAY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-0891
Practice Address - Country:US
Practice Address - Phone:704-849-8621
Practice Address - Fax:704-849-7349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409689Medicaid