Provider Demographics
NPI:1992244602
Name:EARLY INTERVENTION SERVICES, INC.
Entity type:Organization
Organization Name:EARLY INTERVENTION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:WROBBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-830-6562
Mailing Address - Street 1:4501 HILL RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-3519
Mailing Address - Country:US
Mailing Address - Phone:618-830-6562
Mailing Address - Fax:618-503-0263
Practice Address - Street 1:4501 HILL RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IL
Practice Address - Zip Code:62249-3519
Practice Address - Country:US
Practice Address - Phone:618-830-6562
Practice Address - Fax:618-503-0263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency