Provider Demographics
NPI:1255964870
Name:GROUP INTERVENTIONS
Entity type:Organization
Organization Name:GROUP INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-644-4103
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:SAINT JACOB
Mailing Address - State:IL
Mailing Address - Zip Code:62281-0428
Mailing Address - Country:US
Mailing Address - Phone:618-644-4103
Mailing Address - Fax:618-644-3659
Practice Address - Street 1:6600 W MAIN ST STE 4B
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223-3037
Practice Address - Country:US
Practice Address - Phone:618-644-4103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health