Provider Demographics
NPI:1467240861
Name:SG INTERVENTION LLC
Entity type:Organization
Organization Name:SG INTERVENTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GITTY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:917-618-4187
Mailing Address - Street 1:4515 12TH AVE APT D5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2007
Mailing Address - Country:US
Mailing Address - Phone:917-618-4187
Mailing Address - Fax:
Practice Address - Street 1:4515 12TH AVE APT D5
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2007
Practice Address - Country:US
Practice Address - Phone:917-618-4187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management