Provider Demographics
NPI:1881943504
Name:LITTLE ONESEARLY INTERVENTION LLC.
Entity type:Organization
Organization Name:LITTLE ONESEARLY INTERVENTION LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:803-960-7780
Mailing Address - Street 1:528 KOON STORE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-9450
Mailing Address - Country:US
Mailing Address - Phone:803-960-7780
Mailing Address - Fax:
Practice Address - Street 1:528 KOON STORE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-9450
Practice Address - Country:US
Practice Address - Phone:803-960-7780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty