Provider Demographics
NPI:1053533133
Name:THE SYSTEM OF INTERVENTION
Entity type:Organization
Organization Name:THE SYSTEM OF INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY OF CORPORATION
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:BRIDGES
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-371-6044
Mailing Address - Street 1:712 LAFAYETTE AVE.
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-6269
Mailing Address - Country:US
Mailing Address - Phone:812-371-6044
Mailing Address - Fax:812-314-4962
Practice Address - Street 1:712 LAFAYETTE AVE.
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-6269
Practice Address - Country:US
Practice Address - Phone:812-371-6044
Practice Address - Fax:812-314-4962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health