1306582267 NPI number — INNOVATIVE HEALTHCARE TRAINING, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306582267 NPI number — INNOVATIVE HEALTHCARE TRAINING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INNOVATIVE HEALTHCARE TRAINING, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NEXT LEVEL MENTAL HEALTH SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306582267
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 CRAIN HWY S STE 2B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN BURNIE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21061-3526
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-410-3570
Provider Business Mailing Address Fax Number:
443-410-3592

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 CRAIN HWY S STE 2B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLEN BURNIE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21061-3526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-410-3570
Provider Business Practice Location Address Fax Number:
443-410-3592
Provider Enumeration Date:
05/12/2022

Additional Information

Authorized Official

Authorized Official Last Name:
GREENE
Authorized Official First Name:
DR. CRYSTAL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
443-410-3570

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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