Provider Demographics
NPI:1932360500
Name:TIMELY INTERVENTION & PREVENTIVE SERVICES, INC. (T.I.P.S., INC)
Entity Type:Organization
Organization Name:TIMELY INTERVENTION & PREVENTIVE SERVICES, INC. (T.I.P.S., INC)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:252-904-8613
Mailing Address - Street 1:PO BOX 6774
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27802-6774
Mailing Address - Country:US
Mailing Address - Phone:252-904-8613
Mailing Address - Fax:252-972-9840
Practice Address - Street 1:749 REDGATE AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-5917
Practice Address - Country:US
Practice Address - Phone:252-904-8613
Practice Address - Fax:252-972-9840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health