Organization Name: | INNOVATIVE HOUSING |
NPI Number: | 1366878860 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALISON FLYNN (ECS SUPERVISOR) |
Mailing Address: | 3051 Commerce Dr Fort Gratiot |
State: | MI US |
Postal Code: | 480593866 |
Phone Number: | 8103854463 |
Fax Number: | |
NPI Enumeration Date: | 09/17/2013 |
NPI Last Update Date: | 09/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |