Provider Demographics
NPI:1669275020
Name:EARLY BIRD INTERVENTIONS
Entity type:Organization
Organization Name:EARLY BIRD INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INFANT TODDLER FAMILY SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JIMMIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-835-5370
Mailing Address - Street 1:99 DOUBLE KNOBS TRAIL
Mailing Address - Street 2:
Mailing Address - City:YOUNG HARRIS
Mailing Address - State:GA
Mailing Address - Zip Code:30582
Mailing Address - Country:US
Mailing Address - Phone:706-835-5370
Mailing Address - Fax:
Practice Address - Street 1:99 DOUBLE KNOBS TRAIL
Practice Address - Street 2:
Practice Address - City:YOUNG HARRIS
Practice Address - State:GA
Practice Address - Zip Code:30582
Practice Address - Country:US
Practice Address - Phone:706-835-5370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency