Provider Demographics
NPI:1538766753
Name:METHODIST TRAINING & OUTREACH CENTER, INC
Entity type:Organization
Organization Name:METHODIST TRAINING & OUTREACH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERMA
Authorized Official - Middle Name:C
Authorized Official - Last Name:DERIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-714-7782
Mailing Address - Street 1:PO BOX 306816
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00803-6816
Mailing Address - Country:US
Mailing Address - Phone:340-714-7782
Mailing Address - Fax:
Practice Address - Street 1:4A KRONPRINDSENS GADE
Practice Address - Street 2:
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-6451
Practice Address - Country:US
Practice Address - Phone:340-715-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty