Provider Demographics
NPI:1023357647
Name:SUPPORT INNOVATIONS INC.
Entity Type:Organization
Organization Name:SUPPORT INNOVATIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEINLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-205-0588
Mailing Address - Street 1:13422 CLAYTON RD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1008
Mailing Address - Country:US
Mailing Address - Phone:314-205-0588
Mailing Address - Fax:
Practice Address - Street 1:13422 CLAYTON RD
Practice Address - Street 2:SUITE 214
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1008
Practice Address - Country:US
Practice Address - Phone:314-205-0588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities