1649671520 NPI number — MULTI-THERAPEUTIC SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649671520 NPI number — MULTI-THERAPEUTIC SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MULTI-THERAPEUTIC SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649671520
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2625 NEUDORF RD
Provider Second Line Business Mailing Address:
SUITE 600
Provider Business Mailing Address City Name:
CLEMMONS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27012-7844
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-778-2520
Provider Business Mailing Address Fax Number:
336-778-2521

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
602 TANGLE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMESTOWN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27282-9443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-778-2520
Provider Business Practice Location Address Fax Number:
336-778-2521
Provider Enumeration Date:
09/10/2014

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
TONI
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
336-813-0723

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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