| Intervention Services Of Southeast Alabama, Llc | |
|
557 Glover Ave Enterprise AL 36330-2024 | |
| (334) 308-2292 | |
| Not Available |
| Full Name | Intervention Services Of Southeast Alabama, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 557 Glover Ave, Enterprise, Alabama |
| Authorized Official Name and Position | Jessyca Renae Coleman (THERAPIST) |
| Authorized Official Contact | 3344060816 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Intervention Services Of Southeast Alabama, Llc 108 Crest Hill Dr Enterprise AL 36330-4474 Ph: (334) 406-0816 | Intervention Services Of Southeast Alabama, Llc 557 Glover Ave Enterprise AL 36330-2024 Ph: (334) 308-2292 |
| NPI Number | 1285340406 |
|---|---|
| Provider Enumeration Date | 01/31/2023 |
| Last Update Date | 01/31/2023 |
| Certification Date | 01/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285340406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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