Provider Demographics
NPI:1104644319
Name:INTERACTIVE INTERVENTIONS
Entity type:Organization
Organization Name:INTERACTIVE INTERVENTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SLATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-915-8877
Mailing Address - Street 1:1301 STAPLETON DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-4668
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:119 POOLE BRIDGE DR
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-5839
Practice Address - Country:US
Practice Address - Phone:540-915-8877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty