Provider Demographics
NPI:1912418765
Name:SAVED FOUNDATION
Entity Type:Organization
Organization Name:SAVED FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:PAULISHA
Authorized Official - Middle Name:DA-SHAWNA
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:BSW, MSW,LCSW-A
Authorized Official - Phone:336-455-0018
Mailing Address - Street 1:5604 WESLO WILLOW CIR APT 217
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-1708
Mailing Address - Country:US
Mailing Address - Phone:336-455-0018
Mailing Address - Fax:
Practice Address - Street 1:432 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5648
Practice Address - Country:US
Practice Address - Phone:336-617-3152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0120701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty