INNOVATIVE ADDICTION SERVICES NPI 1356931513

NPI Information

NPI: 1356931513
Provider Name: INNOVATIVE ADDICTION SERVICES
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
3721 W MICHIGAN AVE STE 200
LANSING, MI
ZIP 48917
Phone: (517) 515-6176
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INNOVATIVE ADDICTION SERVICES is a rehabilitation and substance use disorder clinic center in Lansing, MI. INNOVATIVE ADDICTION SERVICES NPI is 1356931513. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3721 W MICHIGAN AVE STE 200
LANSING, MI
ZIP 48917-600
Phone: (517) 515-6176

The provider's authorized official is Ricardo David Tillery .
The authorized official title is Ceo and has the following contact phone number (517) 703-3387.

The enumeration date for this NPI number is 1/21/2021 and was last updated on 1/21/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	261QC1500X	Clinic/Center	Community Health	No
3	3245S0500X	Substance Abuse Rehabilitation Facility	Substance Abuse Treatment, Children	No
4	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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