Provider Demographics
NPI:1184411993
Name:EARLY IDENTIFICATION EARLY INTERVENTION OUTREACH PROGRAM (EIEIOP)
Entity type:Organization
Organization Name:EARLY IDENTIFICATION EARLY INTERVENTION OUTREACH PROGRAM (EIEIOP)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERNA
Authorized Official - Middle Name:W
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:252-299-8501
Mailing Address - Street 1:2302 NASH ST N STE 168
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27896-1741
Mailing Address - Country:US
Mailing Address - Phone:252-299-8501
Mailing Address - Fax:252-291-3137
Practice Address - Street 1:2302 NASH ST N STE 168
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27896-1741
Practice Address - Country:US
Practice Address - Phone:252-299-8501
Practice Address - Fax:252-291-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No251S00000XAgenciesCommunity/Behavioral Health