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INNOVATIVE SUPPORT SERVICES LLC NPI 1790964625


NPI Information

NPI: 1790964625
Provider Name: INNOVATIVE SUPPORT SERVICES, LLC
Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization
Address:
2730 OLDENWAY DR
CHARLOTTE, NC
ZIP 28269
Phone: (704) 856-2293
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INNOVATIVE SUPPORT SERVICES, LLC is a day training developmentally disabled services in Charlotte, NC. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. INNOVATIVE SUPPORT SERVICES, LLC NPI is 1790964625. The provider is registered as an organization entity type.

The provider's business location address is:

2730 OLDENWAY DR
CHARLOTTE, NC
ZIP 28269-772
Phone: (704) 856-2293
Fax: (704) 856-2294

The provider's authorized official is Adriane Berry Jackson .
The authorized official title is EXECUTIVE DIRECTORDirector and has the following contact phone number (704) 856-2293.

The enumeration date for this NPI number is 10/28/2007 and was last updated on 7/23/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251C00000XDay Training, Developmentally Disabled ServicesYes

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

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