Provider Demographics
NPI:1356198584
Name:INNOVATED HEALTHCARE SERVICES
Entity type:Organization
Organization Name:INNOVATED HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LILU
Authorized Official - Middle Name:
Authorized Official - Last Name:MAREALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:170-372-5750
Mailing Address - Street 1:609 H ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3731
Mailing Address - Country:US
Mailing Address - Phone:703-725-7505
Mailing Address - Fax:
Practice Address - Street 1:609 H ST NW STE 321
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3731
Practice Address - Country:US
Practice Address - Phone:703-725-7505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital