Provider Demographics
NPI:1699536524
Name:INTERVENTION GUIDANCE RESOURCES
Entity type:Organization
Organization Name:INTERVENTION GUIDANCE RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:C
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BSC
Authorized Official - Phone:267-254-2453
Mailing Address - Street 1:712 SPRING LN
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1038
Mailing Address - Country:US
Mailing Address - Phone:267-254-2453
Mailing Address - Fax:
Practice Address - Street 1:712 SPRING LN
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1038
Practice Address - Country:US
Practice Address - Phone:267-254-2453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency