Provider Demographics
NPI:1811047095
Name:INTERVENTION SPECIALISTS LLC
Entity type:Organization
Organization Name:INTERVENTION SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PAGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-289-0700
Mailing Address - Street 1:453 MORRIS AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07207
Mailing Address - Country:US
Mailing Address - Phone:908-289-0700
Mailing Address - Fax:908-289-3913
Practice Address - Street 1:453 MORRIS AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07207
Practice Address - Country:US
Practice Address - Phone:908-289-0700
Practice Address - Fax:908-289-3913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Not Answered261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0050121OtherWFNJ
NJ0050091Medicaid