Organization Name: | INNOVATIVE SUPPORT SERVICES, LLC |
NPI Number: | 1184923054 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEPHANIE KIRNES (EXECUTIVE DIRECTOR) |
Mailing Address: | 310 Modest St Lakeland |
State: | FL US |
Postal Code: | 338053123 |
Phone Number: | 8639048820 |
Fax Number: | 8662715349 |
NPI Enumeration Date: | 03/18/2011 |
NPI Last Update Date: | 03/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |