Provider Type Icon

INNOVATIVE SOLUTIONS PERSONAL CARE HOME NPI 1730621756


NPI Information

NPI: 1730621756
Provider Name: INNOVATIVE SOLUTIONS PERSONAL CARE HOME

Doing Business As: INNOVATIVE SOLUTIONS PERSONAL CARE HOME

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
569 PHYLLIS CIR
CAMILLA, GA
ZIP 31730
Phone: (229) 462-2055
Get Directions

INNOVATIVE SOLUTIONS PERSONAL CARE HOME is a community based residential treatment facility, intellectual and/or developmental disabilities in Camilla, GA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. INNOVATIVE SOLUTIONS PERSONAL CARE HOME NPI is 1730621756. The provider is registered as an organization entity type.
The provider Is Doing Business As Innovative Solutions Personal Care Home.

The provider's business location address is:

569 PHYLLIS CIR
CAMILLA, GA
ZIP 31730-438
Phone: (229) 462-2055

The provider's authorized official is Tenesha Denise Givens .
The authorized official title is Owner/administrator and has the following contact phone number (229) 462-2055.

The enumeration date for this NPI number is 11/8/2016 and was last updated on 11/8/2016.


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 License Number License State Primary
1320700000XResidential Treatment Facility, Physical DisabilitiesNo
2320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.