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INNOVATIVE LIFE SOLUTIONS, INC.

Intermediate Care Mentally Retarded

Washington, District Of Columbia

Provider NPI: 1518228063

Organization Information:
Organization Name:  INNOVATIVE LIFE SOLUTIONS, INC.
Organization is not Subpart
Authorized Official:  DAVID ALLEN CARRINGTON  EXECUTIVE DIRECTOR  301-2704750

Practice Location:
5000 E CAPITOL ST NE  WASHINGTON, DC 20019 US
Tel: 202-399-0150  Fax: 202-399-0151

Business Mailing Address:
6475 NEW HAMPSHIRE AVE SUITE 760 HYATTSVILLE, MD 20783 US
Tel: 301-270-4750  Fax: 301-270-4754

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded

Other Provider Identifiers:

IssuerNumberStateType
UNKNOWNDC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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