| Therapeutic Intervention Services, Inc. | |
|
340 N Sam Houston Pkwy E Ste A217 Houston TX 77060-3305 | |
| (252) 258-4783 | |
| Not Available |
| Full Name | Therapeutic Intervention Services, Inc. |
|---|---|
| Speciality | Case Management |
| Location | 340 N Sam Houston Pkwy E Ste A217, Houston, Texas |
| Authorized Official Name and Position | Antwan Adams (OPERATIONS) |
| Authorized Official Contact | 2522584783 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Intervention Services, Inc. 4803 Red Brush Dr Mc Leansville NC 27301-9314 Ph: () - | Therapeutic Intervention Services, Inc. 340 N Sam Houston Pkwy E Ste A217 Houston TX 77060-3305 Ph: (252) 258-4783 |
| NPI Number | 1770188047 |
|---|---|
| Provider Enumeration Date | 12/03/2020 |
| Last Update Date | 04/25/2022 |
| Certification Date | 04/25/2022 |
| Medicare PECOS PAC ID | 4688080161 |
|---|---|
| Medicare Enrollment ID | O20210308002147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770188047 | NPI | - | NPPES |
| Provider Name | Mambo J Ndingwan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326675737 PECOS PAC ID: 0840604617 Enrollment ID: I20210309001573 |
| Provider Name | Leesha S Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750634416 PECOS PAC ID: 8022439470 Enrollment ID: I20220506001742 |
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